| Regimental number | 6821 |
| Place of birth | Cambridge England |
| Religion | Church of England |
| Occupation | Soldier |
| Address | Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs Rosa Gray, 163 Freshfield Road, Brighton, England |
| Enlistment date | 11 May 1917 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/34/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 16 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps Details |
| Fate | Returned to Australia 6 September 1919 |
