| Regimental number | 2566 |
| Religion | Methodist |
| Occupation | Labourer |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mrs Rachel Bell, 18 Byron Street, St Kilda South, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 21st Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/38/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Moldavia on |
| Fate | No details of fate entered on Nominal Roll |