| Regimental number | 19786 |
| Place of birth | Ballarat Victoria |
| Religion | Church of England |
| Occupation | Electrician |
| Address | Paddington, New South Wales |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs H M Gillham, c/o Robson's Buildings, Elizabeth and Liverpool Streets, Sydney, New South Wales |
| Enlistment date | 2 January 1918 |
| Rank on enlistment | Private |
| Unit name | Hospital Transport Corps |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board No 2 Hospital Ship Kanowna on 25 September 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | No 2 Hospital Ship 'Kanowna' Staff |
| Fate | Effective abroad (still overseas) |
