| Regimental number | 11990 |
| Place of birth | Bathurst New South Wales |
| Religion | Church of England |
| Occupation | Salesman |
| Address | Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs Emma Jackson, 127 Bridge Road, Glebe Point, Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Driver |
| Unit name | Field Ambulance 9, Section B |
| AWM Embarkation Roll number | 26/52/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A24 Benalla on |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 2nd Australian General Hospital |
| Fate | Effective abroad (still overseas) |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
