| Regimental number | 2685 |
| Date of birth | |
| Place of birth | Adelaide South Australia |
| Religion | Methodist |
| Occupation | Salesman |
| Address | Annesley Avenue, North Norwood, South Australia |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Beatrice Potts, Annesley Avenue, North Norwood, South Australia |
| Enlistment date | |
| Rank on enlistment | CPL Pack Storekeeper |
| Unit name | 4th Light Horse Field Ambulance |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A30 Borda on |
| Regimental number from Nominal Roll | Commissioned |
| Rank from Nominal Roll | 2nd Lieutenant |
| Unit from Nominal Roll | 8th Field Ambulance |
| Promotions |
2nd Lieutenant Unit: INF53 Promotion date: Lieutenant Unit: INF53 Promotion date: |
| Fate | Returned to Australia |