| Regimental number | 41A |
| Place of birth | Stawell Victoria |
| Religion | Church of England |
| Occupation | Salesman |
| Address | Ballarat, Victoria |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, J Jeffery, 314 Drummond Street, Ballarat, Victoria |
| Enlistment date | 16 April 1915 |
| Rank on enlistment | Private |
| Unit name | No 1 Australian General Hospital |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board A62 Wandilla on 25 June 1915 |
| Regimental number from Nominal Roll | 41 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Australian Auxiliary Hospital |
| Fate | Returned to Australia 11 April 1916 |