| Regimental number | 4873 |
| Place of birth | Stellerup, Denmark |
| Religion | Church of England |
| Occupation | Labourer |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Mother, Mrs Johanna Mathisen, Bleggaardlgadl, Vell, Denmark |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 1st Pioneer Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 14/13/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A38 Ulysses on |
| Age at death from cemetery records | 33 |
| Place of burial | Cerisy-Gailly Military Cemetery (Plot I, Row b, Grave No. 21), France |
| Panel number, Roll of Honour, Australian War Memorial | 174 |
| Miscellaneous information from cemetery records | Parents: Peder and Johanna MATHISEN, ribevg, 161B, Veile, Denmark |