| Regimental number | 1019 |
| Place of birth | Newport Wales |
| Religion | Baptist |
| Occupation | Miner |
| Address | Edden Street, Adamstown, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | B Harris, Lewis Street, Machin, South Wales, England |
| Enlistment date | 19 October 1914 |
| Rank on enlistment | Private |
| Unit name | Field Ambulance 4, Section A |
| AWM Embarkation Roll number | 26/47/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board Transport A35 Berrima on 22 December 1914 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Field Ambulance |
| Fate | Returned to Australia 25 March 1919 |
