| Regimental number | 21749 |
| Place of birth | Birmingham England |
| Religion | Presbyterian |
| Occupation | Hospital attendant |
| Address | South Yarra, Victoria |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs A H Hayden, 32 River Street, South Yarra, Victoria |
| Enlistment date | 15 September 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian General Hospital |
| Fate | Returned to Australia 28 August 1919 |
