| Regimental number | 803 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Student |
| Address | c/o Dr Adey, Hospital for Insane, Kew |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs H E Adey, c/o Dr Adey, Hospital for Insane, Kew |
| Enlistment date | |
| Rank on enlistment | Corporal |
| Unit name | 3rd Light Horse Field Ambulance |
| AWM Embarkation Roll number | 26/41/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A51 Chilka on |
| Rank from Nominal Roll | Staff Sergeant |
| Unit from Nominal Roll | 3rd Light Horse Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
