| Regimental number | 13822 |
| Religion | Church of Denmark |
| Occupation | Male nurse |
| Marital status | Single |
| Age at embarkation | 42 |
| Next of kin | Sister, Mrs H Aagaard, Herberg for Tgemlose, 54 Dr Tvorgade, Copenhagen, Denmark |
| Enlistment date | 21 November 1915 |
| 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 29 March 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
