| Regimental number | 17161 |
| Place of birth | Parkside, South Australia |
| Religion | Baptist |
| Occupation | Clerk |
| Address | Mile End, South Australia |
| Marital status | Married |
| Age at embarkation | 22 |
| Next of kin | Wife, Mrs A O Berry, 25 Fisher Terrace, Mile End, South Australia |
| Enlistment date | 1 October 1916 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps February 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A30 Borda on 23 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia 1 November 1917 |
