| Regimental number | 2011 |
| Place of birth | Newcastle New South Wales |
| Religion | Church of England |
| Occupation | Medical student |
| Address | Newcomen Street, Newcastle, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Dr Nickson, Newcomen Street, Newcastle, New South Wales |
| Enlistment date | |
| Rank on enlistment | S/SGT |
| Unit name | Field Ambulance 4, Section A |
| AWM Embarkation Roll number | 26/47/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board Transport A35 Berrima on |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 4th Field Ambulance |
| Recommendations (Medals and Awards) |
Mention in Despatches Awarded, and promulgated, 'London Gazette', Supplement No. 29455 (28 January 1916); 'Commonwealth Gazette' No. 44 (6 April 1916). |
| Fate | Returned to Australia |