| Regimental number | 13879 |
| Place of birth | Holberton England |
| Religion | Church of England |
| Occupation | Chemist (dental) |
| Address | Kogarah, New South Wales |
| Marital status | Married |
| Age at embarkation | 45 |
| Next of kin | Wife, Mrs M E Ford, Gray Street, Kogarah, New South Wales |
| Enlistment date | 1 September 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Morea on 21 August 1915 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Morea on 24 August 1915 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A63 Karoola on 18 December 1915 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A29 Suevic on 23 December 1915 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A63 Karoola on 7 March 1916 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A63 Karoola on 14 March 1916 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on 29 March 1916 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A61 Kanowna on 1 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian Army Hospital |
| Fate | Returned to Australia 13 March 1918 |
