| Regimental number | 12617 |
| Place of birth | Adelaide South Australia |
| Religion | Church of England |
| Occupation | Railway employee |
| Address | 24 Corryton Street, Adelaide, South Australia |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs Zillah Emma Harrison, 24 Corryton Street, Adelaide, South Australia |
| Enlistment date | 6 January 1916 |
| Rank on enlistment | Private |
| Unit name | 11th Field Ambulance |
| AWM Embarkation Roll number | 26/54/1 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A29 Suevic on 31 May 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Convalescent Depot |
| Fate | Returned to Australia 20 June 1919 |
