| Regimental number | 120 |
| Religion | Church of England |
| Occupation | Student |
| Address | Baker Street, Castlemaine, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, Frederick House, Castlemaine, Victoria |
| Enlistment date | 10 May 1915 |
| Rank on enlistment | Private |
| Unit name | |
| AWM Embarkation Roll number | 26/84/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Mooltan on 18 May 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps Details |
| Fate | Returned to Australia 12 December 1915 |
| Miscellaneous details (Nominal Roll) | *Second entry both matched |
