| Regimental number | 13563 |
| Place of birth | Hobart Tasmania |
| Religion | Church of England |
| Occupation | Builder |
| Address | Hobart, Tasmania |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Ms S J Lange, 81 Goulburn Street, Hobart, Tasmania |
| Enlistment date | 19 October 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A61 Kanowna on 1 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Corps Reinforcements Camp |
| Fate | Returned to Australia 17 March 1919 |
| Date of death | 31 October 1958 |
| Place of burial | Eastern Suburbs Memorial Park Cemetery |
