| Regimental number | 13619 |
| Place of birth | Gympie Queensland |
| Religion | Salvation Army |
| Occupation | Farmer |
| Address | Sandgate, Queensland |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs P J Jenkins, 'Marina', Fifth Avenue, Sandgate, Queensland |
| Enlistment date | 5 October 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on 29 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Australian Auxiliary Hospital |
| Fate | Returned to Australia 8 April 1917 |
