| Regimental number | 9134A |
| Place of birth | Carlton Victoria |
| Religion | Church of England |
| Occupation | Chemist's assistant |
| Address | South Yarra, Victoria |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Father, D Lewis, 76 Hope Street, South Yarra, Victoria |
| Previous military service | 17th Australian Army Medical Corps |
| Enlistment date | 14 July 1915 |
| Rank on enlistment | Private |
| Unit name | Convalescent Depot, Harefield Park, London, and Special Reinforcements (Feb 1915 - March 1916) |
| Embarkation details | Unit embarked from Melbourne, Vic, on board HMAT A63 Karoola on 1 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Field Ambulance |
| Fate | Returned to Australia 23 June 1919 |
