| Regimental number | 19119 |
| Place of birth | Liverpool England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Maldon, Victoria |
| Marital status | Married |
| Age at embarkation | 37 |
| Next of kin | Wife, Mrs J Merchant, c/o Mrs Roberts, North Maldon, Victoria |
| Enlistment date | 2 January 1917 |
| Date of enlistment from Nominal Roll | 2 February 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, September 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 22 December 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian General Hospital |
| Fate | Returned to Australia 13 July 1919 |