| Regimental number | 21072 |
| Place of birth | Lancashire England |
| Religion | Church of England |
| Occupation | Salesman |
| Address | Bondi, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs H Jackson, 108 Hibson Road, Nelson, Lancashire, England |
| Enlistment date | 3 August 1918 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Carpentaria on 7 November 1918 |
| Miscellaneous details (Nominal Roll) | Ship subsequently recalled owing to cessation of hostilities. |
| Other details | Medal: British War Medal |
