| Regimental number | 13288 |
| Place of birth | St Kilda Victoria |
| Religion | Baptist |
| Occupation | Carpenter |
| Address | Surrey Hills, Victoria |
| Marital status | Married |
| Age at embarkation | 43 |
| Next of kin | Wife, Mrs E G Fuller, 177 Elgar Road, Surrey Hills, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A63 Karoola on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 14th Field Ambulance |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |