| Regimental number | 19562 |
| Place of birth | Footscray Victoria |
| Religion | Church of England |
| Occupation | Dental mechanic |
| Address | Footscray, Victoria |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Father, T Otter, 1 Collins Street, Footscray, Victoria |
| Enlistment date | 9 November 1917 |
| Date of enlistment from Nominal Roll | 7 November 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, October 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Orontes on 5 June 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Field Ambulance |
| Fate | Returned to Australia 25 September 1919 |
