| Regimental number | 4758 |
| Place of birth | Newcastle New South Wales |
| Religion | Church of England |
| Occupation | Farm hand |
| Address | Hawthorn Parade, Haberfield, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs L A Warner, 154 Hawthorn Parade, Haberfield, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/36/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Rookwood Crematorium |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
