| Regimental number | 6196 |
| Place of birth | Adelaide, South Australia |
| Religion | Roman Catholic |
| Occupation | Caretaker |
| Address | 8 St George's Terrace, Perth, Western Australia |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | Wife, Mrs Lilian Bastow, 8 St George's Terrace, Perth, Western Australia |
| Enlistment date | 8 September 1914 |
| Rank on enlistment | Private |
| Unit name | Field Ambulance 4, Reinforcement 11 |
| AWM Embarkation Roll number | 26/47/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A24 Benalla on 1 November 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Field Ambulance |
| Fate | Returned to Australia 1 July 1919 |
