| Regimental number | 7108 |
| Place of birth | Svendborg Denmark |
| Religion | Presbyterian |
| Occupation | Labourer |
| Address | Paddington, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Father, John Petersen, Svendborg, Denmark |
| Enlistment date | 26 October 1917 |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/36/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 28 February 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 19th Battalion |
| Fate | Returned to Australia 22 August 1919 |