| Regimental number | 17084 |
| Place of birth | Broadford Victoria |
| Religion | Church of England |
| Occupation | Motorman |
| Address | 21 Thomas Street, Moonee Ponds, Victoria |
| Marital status | Married |
| Age at embarkation | 24 |
| Next of kin | Wife, Mrs Mary Elizabeth Parker, 21 Thomas Street, Moonee Ponds, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 3rd Light Horse Field Ambulance, 26th Reinforcement |
| AWM Embarkation Roll number | 26/41/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Morea on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Light Horse Regiment |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Broadford Cemetery |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
