| Regimental number | 5903 |
| Place of birth | Normanville South Australia |
| Religion | Roman Catholic |
| Occupation | Barman |
| Address | Cremorne Hotel, Perth, Western Australia |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Father, Carl Christian Nielsen, Normansville, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A23 Suffolk on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 28th Battalion |
| Fate | Returned to Australia |
| Other details |
War service: Western Front |
| Date of death | |
| Age at death | 67 |
| Place of burial | AIF Cemetery (Row 9, Grave 39), West Terrace, Adelaide, South Australia |