| Regimental number | 13622 |
| Place of birth | Cooktown Queensland |
| Religion | Church of England |
| Occupation | Printer |
| Address | North Ipswich, Queensland |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs M King, The Terrace, North Ipswich, Queensland |
| Previous military service | 11th Infantry |
| Enlistment date | 7 December 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on 29 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Field Ambulance |
| Fate | Returned to Australia 16 June 1919 |