| Regimental number | 4968 |
| Place of birth | Enmore New South Wales |
| Religion | Church of England |
| Occupation | Clerk |
| Address | 'Manaia', Muston Street, Mosman, New South Wales |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs M Jacob, 'Manaia', Muston Street, Mosman, Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Corporal |
| Unit name | Australian Army Medical Corps, Hospital Transports Staff (No. 1 Hospital Ship, 'Karoola') |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on |
| Rank from Nominal Roll | Warrant Officer (Class I) |
| Unit from Nominal Roll | 1st Light Horse Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
