| Regimental number | 6643 |
| Place of birth | Sandringham Victoria |
| Religion | Methodist |
| Occupation | Civil servant |
| Address | Sans Sonce, Bay Road, Sandringham |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs E Percy, Sans Sonce, Bay Road, Sandringham |
| Enlistment date | 20 July 1915 |
| Rank on enlistment | Private |
| Unit name | Infantry Brigade 6, Field Ambulance 6, Reinforcement 10 |
| AWM Embarkation Roll number | 26/49/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on 7 March 1916 |
| Regimental number from Nominal Roll | 9643 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Field Ambulance |
| Fate | Returned to Australia 31 May 1919 |
