| Regimental number | 1142 |
| Place of birth | Yackandandah, Victoria |
| Religion | Roman Catholic |
| Occupation | Agent |
| Address | Emu Park, via Rockhampton, Queensland |
| Marital status | Married |
| Age at embarkation | 39.2 |
| Height | 5' 11" |
| Weight | 161 lbs |
| Next of kin | Wife, Mrs Jeannie Madsen, Emu Park, via Rockhampton, Queensland |
| Previous military service | Served for 18 months in 2nd Australian Commonwealth Horse, South Africa (Boer War). |
| Enlistment date | |
| Place of enlistment | Rockhampton, Queensland |
| Rank on enlistment | Private |
| Unit name | Australian Naval and Military Expeditionary Force, Army Medical Corps |
| AWM Embarkation Roll number | 23/112/5 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board SS Makambo on |
| Rank from Nominal Roll | Private |
| Fate | Returned to Australia |
| Other details |
War service: Rabaul Medal: British War Medal |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
