| Regimental number | 60921 |
| Place of birth | Newcastle New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 12 Dally Street, Northcote, Victoria |
| Marital status | Married |
| Age at embarkation | 20 |
| Next of kin | Wife, Mrs M L Ford, 12 Dally Street, Northcote, Victoria |
| Previous military service | 54th Infantry |
| Enlistment date | 3 June 1918 |
| Rank on enlistment | Private |
| Unit name | 9th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A37 Barambah on 31 August 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps Details |
| Fate | Effective abroad (still overseas) |
