| Regimental number | 53776 |
| Place of birth | Goulburn New South Wales |
| Religion | Church of England |
| Occupation | Cook |
| Address | Auburn, New South Wales |
| Marital status | Single |
| Age at embarkation | 34 |
| Next of kin | Mother, Mrs M Mitchell, Hargreave Street, Auburn, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 4 |
| AWM Embarkation Roll number | 23/111/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Feldmarschall on |
| Rank from Nominal Roll | Private |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
