| Regimental number | 4996 |
| Place of birth | Nelligen New South Wales |
| Religion | Church of England |
| Occupation | Pitman |
| Address | 52 Glenview Street, Paddington, New South Wales |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs Emma Johnson, 52 Glenview Street, Paddington, New South Wales |
| Enlistment date | 8 April 1915 |
| Rank on enlistment | Private |
| 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 14 July 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Field Ambulance |
| Fate | Returned to Australia 14 January 1919 |
