| Regimental number | 184 |
| Place of birth | Charlton Victoria |
| Religion | Presbyterian |
| Occupation | Hairdresser |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Mrs A B Fisher, Charlton, via Bendigo, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 3rd Field Ambulance, C Squadron |
| AWM Embarkation Roll number | 26/46/1 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A7 Medic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Field Ambulance |
| Fate | Returned to Australia |
| Medals |
Silver Medal (Serbia) Source: 'Commonwealth Gazette' No. 169 Date: |