| Religion | Presbyterian |
| Occupation | Medical practitioner |
| Address | Hawthorn, Victoria |
| Marital status | Married |
| Age at embarkation | 39 |
| Next of kin | Wife, Mrs H C Black, 23 Mary Street, Hawthorn, Victoria |
| Enlistment date | |
| Rank on enlistment | Captain |
| Unit name | Medical Officers |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Hawkes Bay on |
| Rank from Nominal Roll | Captain |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia |