| Regimental number | 17583 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Chemist's assistant |
| Address | 191 George Street, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 21 |
| Next of kin | Wife, Mrs Lilly Nell, 191 George Street, Sydney, New South Wales |
| Previous military service | 30th Australian Army Medical Corps |
| Enlistment date | 2 April 1917 |
| Date of enlistment from Nominal Roll | 31 March 1917 |
| Rank on enlistment | Private |
| Unit name | 1st Light Horse Field Ambulance, 28th Reinforcement |
| AWM Embarkation Roll number | 26/39/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A17 Port Lincoln on 11 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Light Railway Operating Company |
| Fate | Returned to Australia 26 December 1918 |
