| Regimental number | 6356 |
| Place of birth | Dubbo New South Wales |
| Religion | Roman Catholic |
| Occupation | Cement tester |
| Address | P O Bodangora, via Wellington, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mrs M W Kelly, P O Bodangora, via Wellington, New South Wales |
| Enlistment date | 11 May 1915 |
| Rank on enlistment | Private |
| Unit name | 1st Field Ambulance, Reinforcement 12 |
| AWM Embarkation Roll number | 26/44/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on 10 November 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian General Hospital |
| Fate | Returned to Australia 3 March 1919 |
