| Regimental number | 4349 |
| Religion | Church of England |
| Occupation | Poultry farmer |
| Address | Katoomba, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, A H Bacon, Hope Street, Katoomba, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 3rd Australian General Hospital |
| AWM Embarkation Roll number | 26/67/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on |
| Miscellaneous details (Nominal Roll) | See other |