| Regimental number | 904 |
| Place of birth | Drouin Victoria |
| Religion | Baptist |
| Occupation | Horse driver |
| Address | 23 Richardson Street, South Melbourne, Victoria |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs N McDonald, 23 Richardson Street, South Melbourne, Victoria |
| Enlistment date | 28 October 1914 |
| Rank on enlistment | Driver |
| Unit name | 3rd Light Horse Field Ambulance |
| AWM Embarkation Roll number | 26/41/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A51 Chilka on 2 February 1915 |
| Fate | No details of fate entered on Nominal Roll |
