| Regimental number | 4962 |
| Place of birth | Sydney New South Wales |
| Religion | Roman Catholic |
| Occupation | Hospital attendant |
| Address | Gilbert Street, North Parramatta, New South Wales |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | W P Koen, Gilbert Street, North Parramatta, New South Wales |
| Enlistment date | 3 July 1915 |
| Date of enlistment from Nominal Roll | "EA" |
| Rank on enlistment | Corporal |
| Unit name | Australian Army Medical Corps, Hospital Transports Staff (No. 1 Hospital Ship, 'Karoola') |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on 14 July 1915 |
| Rank from Nominal Roll | Staff Sergeant |
| Miscellaneous details (Nominal Roll) | No. 1 Australian Hospital Ship |