| Place of birth | Kew Victoria |
| Occupation | Medical practitioner |
| Address | 59 Avoca Street, South Yarra, Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs Jane Mary Johnson, 59 Avoca Street, South Yarra, Melbourne, Victoria |
| Enlistment date | 17 March 1916 |
| Rank on enlistment | Captain |
| Unit name | 3rd Australian Casualty Clearing Station |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A7 Medic on 20 May 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
