| Regimental number | 21734 |
| Place of birth | Fitzroy Victoria |
| Religion | Roman Catholic |
| Occupation | Dental mechanic |
| Address | Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs M A Mitty, 53 Bourke Street, Melbourne, Victoria |
| Enlistment date | 9 July 1918 |
| Date of enlistment from Nominal Roll | 15 July 1918 |
| Rank on enlistment | Staff Sergeant |
| Unit name | Dental Details |
| AWM Embarkation Roll number | 26/105/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A30 Borda on 17 July 1918 |
| Rank from Nominal Roll | Staff Sergeant |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Effective abroad (still overseas) |
| Miscellaneous details (Nominal Roll) | *Noted Edward Charles NR |
