| Regimental number | 17012 |
| Place of birth | Bundaberg Queensland |
| Religion | Church of England |
| Occupation | Saw sharpener |
| Address | Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, O Peterson, Heat Street, New Farm, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps February 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A16 Port Melbourne on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 7th Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
