| Regimental number | 13631 |
| Religion | Roman Catholic |
| Occupation | Warder |
| Address | Willowburn Hospital, near Toowoomba, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, A Moore, Link Street, Burnside Estate, Toowoomba, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on |
| Rank from Nominal Roll | Gunner |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
