| Regimental number | 18121 |
| Place of birth | Stockyard Creek, South Australia |
| Religion | Congregational |
| Occupation | Reigstered Chemist |
| Address | North Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 37 |
| Next of kin | Wife, Mrs E M D Belcher, 'Pembroke', Clan Alpine Street, Mosman, New South Wales |
| Enlistment date | 10 March 1917 |
| Date of enlistment from Nominal Roll | 1 March 1917 |
| Rank on enlistment | Staff Sergeant |
| Unit name | Staff Sergeant Dispensers |
| AWM Embarkation Roll number | 26/108/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A34 Persic on 29 August 1917 |
| Rank from Nominal Roll | Staff Sergeant |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia 15 January 1919 |
