| Regimental number | 9639 |
| Place of birth | Wangaratta Victoria |
| Religion | Church of England |
| Occupation | Salesman |
| Address | 3 Derby Street, Kew, Victoria |
| Marital status | Married |
| Age at embarkation | 22 |
| Next of kin | Wife, Mrs A Lewry, 3 Derby Street, Kew, Victoria |
| Enlistment date | 30 June 1915 |
| Rank on enlistment | Private |
| Unit name | Infantry Brigade 6, Field Ambulance 6, Reinforcement 10 |
| AWM Embarkation Roll number | 26/49/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on 7 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Field Ambulance |
| Fate | Returned to Australia 25 March 1919 |
