| Regimental number | 17285 |
| Place of birth | Melbourne Victoria |
| Religion | Methodist |
| Occupation | Chairmaker |
| Address | Goodwood, South Australia |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Sister, Mrs M A Rose, North Railway Parade, Goodwood, South Australia |
| Enlistment date | |
| 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 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Field Ambulance |
| Fate | Returned to Australia |
| Miscellaneous information from cemetery records | Plaque in South Australian Garden of Remembrance |
| Date of death |