| Regimental number | 7268 |
| Place of birth | Bornholm Denmark |
| Religion | Lutheran |
| Occupation | Labourer |
| Address | Bendigo, Victoria |
| Marital status | Single |
| Age at embarkation | 37 |
| Next of kin | Father, H F Jorgensen, Ronne, Denmark |
| Enlistment date | 18 December 1916 |
| Rank on enlistment | Private |
| Unit name | 14th Battalion, 24th Reinforcement |
| AWM Embarkation Roll number | 23/31/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A70 Ballarat on 19 February 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 58th Battalion |
| Fate | Returned to Australia 24 July 1919 |
