| Regimental number | 9199 |
| Place of birth | Christiansand Norway |
| Religion | Presbyterian |
| Occupation | Wardman |
| Address | Campbell Street, Wollongong, New South Wales |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Friend, Miss Lily Irvine, Campbell Street, Wollongong, New South Wales |
| Enlistment date | 25 July 1915 |
| Rank on enlistment | Private |
| Unit name | Dermatological Hospital |
| AWM Embarkation Roll number | 26/69/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on 22 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps Details |
| Fate | Returned to Australia 18 July 1919 |