| Regimental number | 17286 |
| Place of birth | Waratah New South Wales |
| Religion | Church of England |
| Occupation | Tram conductor |
| Address | Fitzroy, Victoria |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs B Fox, Rose Street, Armadale, Victoria |
| Enlistment date | 16 February 1916 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, March 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A74 Marathon on 10 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian General Base Depot |
| Fate | Returned to Australia 22 September 1919 |