| Regimental number | 5304 |
| Place of birth | Fitzroy Victoria |
| Religion | Church of England |
| Occupation | Cycle mechanic |
| Address | Kilkenny, South Australia |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs L Paine, Myponga Terrace, Kilkenny, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Convalescent Depot, Harefield Park, London |
| AWM Embarkation Roll number | 26/84/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A67 Orsova on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
