| Regimental number | 17013 |
| Place of birth | Jersey Channel Islands |
| Religion | Church of England |
| Occupation | French polisher |
| Address | Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 37 |
| Next of kin | Mother, Mrs E Mallett, 35 Broad Street, Jersey, Channel Islands |
| Enlistment date | 26 February 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps February 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A16 Port Melbourne on 16 July 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian General Hospital |
| Fate | Returned to Australia 25 September 1919 |
