| Regimental number | 20053 |
| Place of birth | Balmain New South Wales |
| Religion | Congregational |
| Occupation | Chemist's assistant |
| Address | Balmain, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs N Peterson, 403 Darling Street, Balmain, New South Wales |
| Previous military service | 30th Infantry |
| Enlistment date | 28 September 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board SS Gaika on 6 August 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 7th Sanitation Section |
| Fate | Returned to Australia 3 July 1919 |
