| Religion | Methodist |
| Occupation | Coachbuilder |
| Address | Ashfield, New South Wales |
| Marital status | Married |
| Age at embarkation | 50 |
| Next of kin | Wife, Mrs A Hazlett, Holden Street, South Ashfield, New South Wales |
| Enlistment date | |
| Rank on enlistment | Warrant Officer (Class I) |
| Unit name | 3rd Australian General Hospital |
| AWM Embarkation Roll number | 26/67/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on |
| Fate | No details of fate entered on Nominal Roll |