| Regimental number | 2019 |
| Religion | Presbyterian |
| Occupation | Clerk |
| Address | Inglewood, Victoria |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | E C Peverill, Inglewood, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Field Ambulance 4, Section A |
| AWM Embarkation Roll number | 26/47/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board Transport A35 Berrima on |
| Miscellaneous details (Nominal Roll) | see other |