| Regimental number | 1767 |
| Place of birth | Cheshire England |
| Religion | Methodist |
| Occupation | Farmer |
| Address | c/o Frank Hollywell, Beach Road, Bunbury, Western Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Elizabeth Green, 36 Thomas Street, Congleton, England |
| Enlistment date | 18 January 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 4th Reinforcement |
| AWM Embarkation Roll number | 23/28/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A8 Argyllshire on 19 April 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps Details |
| Fate | Effective abroad (still overseas) |
