| Regimental number | 18208 |
| Place of birth | North Melbourne Victoria |
| Religion | Church of England |
| Occupation | Salesman |
| Address | Bendigo, Victoria |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs M J Lane, 45 Shamrock Street, Bendigo, Victoria |
| Enlistment date | 22 March 1917 |
| Rank on enlistment | Private |
| Unit name | June 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A15 Port Sydney on 9 November 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia 17 June 1918 |
