| Regimental number | 61458 |
| Place of birth | Brighton Victoria |
| Religion | Church of England |
| Occupation | Bootmaker |
| Address | 12 Argo Street, South Yarra, Victoria |
| Marital status | Married |
| Age at embarkation | 36 |
| Next of kin | Wife, Mrs A M Pamphilon, 18 Day Street, South Yarra, Victoria |
| Enlistment date | 5 April 1918 |
| Rank on enlistment | Private |
| Unit name | 11th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A37 Barambah on 31 August 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps Details |
| Fate | Effective abroad (still overseas) |
