| Regimental number | 13621 |
| Place of birth | Brisbane Queensland |
| Religion | Church of England |
| Occupation | Warehouseman |
| Address | Teneriffe, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs M Knox, Arthur Street, Teneriffe, Queensland |
| 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 | 7th Field Ambulance |
| Fate | Returned to Australia 16 June 1919 |
