| Regimental number | 17410 |
| Place of birth | Lincolnshire England |
| Religion | Salvation Army |
| Occupation | Cook |
| Address | Port Adelaide, South Australia |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs P Hallam, Greytown, Port Adelaide, South Australia |
| Enlistment date | 19 September 1916 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, March 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A30 Borda on 23 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Machine Gun Battalion |
| Fate | Returned to Australia 12 May 1919 |
