| Regimental number | 16876 |
| Place of birth | Sydney New South Wales |
| Religion | Roman Catholic |
| Occupation | Hospital attendant |
| Address | Glebe Point, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Mary Jackson, 7 Avon Street, Glebe Point, New South Wales |
| Enlistment date | 3 April 1916 |
| Date of enlistment from Nominal Roll | 4 April 1916 |
| Rank on enlistment | Private |
| Unit name | Australian Camel Field Ambulance |
| AWM Embarkation Roll number | 26/60/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A42 Boorara on 10 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Light Horse Field Ambulance |
| Fate | Returned to Australia 15 May 1919 |
| Other details | Medals: British War Medal, Victory Medal |
