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Proof of death, March 3, 1933

6. Date of your first visit, Dec. 9th, 1932. Date

of last visit, Dec. 20, 1932.

7. Place of death, Manhattan General Hosp., 161 E. 9th St., N. Y. City.

8. Who engaged your services? Aetna Life Ins. Co.

9. State in patient's own words how the accident occurred, Hurt carrying a woman up a flight of stairs.

10. Give a complete and accurate description of nature and extent of injury, as you found it upon first and subsequent examinations, Right indirect inguinal hernia which was operated Dec. 9th, 1932. 11. State the direct cause of death, Pulmonary embolus.

12. In your opinion was the accident as above described a cause either directly or indirectly of the death? A. Yes, indirectly.

13. Give contributory causes, if any

14. If coroner's inquest held, give coroner's name and address, County Medical Examiner.

15. Was deceased attended by any other physician during last illness? If so, name and address

16. I am a physician duly licensed in the State of New York, and graduated in the year 1914 from Cornell Medical College.

J. V. Bohrer, Attending Physician.

Address, 116 E. 58th St.

Dated, March 3, 1933.

Notice of hearing, Feb. 5, 1934

247

State of New York, County of....

SS.

.......being duly sworn, deposes and says: That he is the physician who subscribed to the above (or attached) report; that he has read the same and knows the contents thereof; that the same is true to the knowledge of deponent, except as to the matters therein stated to be alleged on information and belief, and as to those matters he believes it to be true. Subscribed and sworn to before me

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Case No. 3225468-3223805-Inj. 9-5-32

William DeVellier (Dec'd) vs. Century Circuit, Inc.
Charlotte Doyle,

96-08 42nd St., Corona, L. I.

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Notice of hearing, Feb. 5, 1934

Century Circuit, Inc.,

152 W. 42nd St., N. Y. C.

Aetna Life Ins. Co.,

100 William St., N. Y. C.

Compensation Service, Inc.,

2 Lafayette St., N. Y. C.

Please take notice that the above case will be presented to the Industrial Board on Tuesday, March 13, 1934, at 2 P. M., on application of the carrier for review of the award to the mother, on the ground that there is insufficient proof of an accidental injury within the meaning of the law; and lack of medical evidence of causal relationship and on the further question of dependency.

The parties in interest are requested to be present or represented at this hearing which will take place at State Office Building, 150 Leonard Street, New York City, on the 4th floor, Room 419.

Yours very truly,

State Industrial Board,
Richard J. Cullen, Chairman,
By G. M. Custer.

MAD.

Vote and decision of Miss Swartz, Mr. Carroll and
Mr. Edwards, July 23, 1935

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VOTE AND DECISION OF MISS SWARTZ, MR.
CARROLL AND MR. EDWARDS, JULY 23, 1935

Inasmuch as you signed the finding of fact and conclusions of law in the above captioned case on appeal, it is hereby referred to you and your attention is called to the memorandum of the Attorney General dated July 18, 1935, stating that neither the Referee nor the Industrial Board has ever excused the failure to give written notice although this question was raised not only at the first and second hearings held, but also the carrier's application for review.

Richard J. Cullen,

Chairman, Industrial Board.

July 24th, 1935: I hereby withdraw my name from the findings of fact and voted to restore the case to the calendar for consideration of the question of notice.

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Decision handed down by Appellate Division,
March 22, 1939

DECISION HANDED DOWN BY APPELLATE
DIVISION, MARCH 22, 1939

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CENTURY CIRCUIT, INC., and AETNA LIFE IN

SURANCE COMPANY,

STATE INDUSTRIAL BOARD,

Respondents,

Respondent.

Appeal from a decision of the State Industrial Board made on January 3, 1938, rescinding a previous award of workmen's compensation and death benefits and disallowing the claims.

The Industrial Board disallowed the claims on the ground that written notice of injury was not given to the employer within the time prescribed by Section 18 of the Workmen's Compensation Law and that this failure had not been excused. Decedent claimed to have been injured on September 5, 1932.

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