| Regimental number | 17199 |
| Place of birth | Zeehan Tasmania |
| Religion | Methodist |
| Occupation | Painter |
| Address | Zeehan, Tasmania |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs E Llewellyn, 4 Bellwood Avenue, Auckland, New Zealand |
| Previous military service | 23rd Australian Army Medical Corps |
| Enlistment date | 16 October 1916 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, March 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 16 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 15th Field Ambulance |
| Fate | Returned to Australia 7 July 1919 |
