| Regimental number | 19212 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Civil servant |
| Address | Perth, Western Australia |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs C Machours, 33 Victoria Street, North Perth, Western Australia |
| Enlistment date | 12 June 1917 |
| Date of enlistment from Nominal Roll | 9 June 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, September 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board SS Canberra on 23 November 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Field Ambulance |
| Fate | Returned to Australia 28 August 1919 |
