| Regimental number | 17633 |
| Place of birth | Northam England |
| Religion | Methodist |
| Occupation | Missionary |
| Address | North Carlton, Victoria |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs F Mellor, Mill Moor Road, Meltham, Huddersfield, Yorkshire, England |
| Enlistment date | 21 February 1916 |
| Date of enlistment from Nominal Roll | 13 January 1916 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, March 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A29 Suevic on 21 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Field Ambulance |
| Fate | Returned to Australia 12 June 1919 |
