| Regimental number | 16886 |
| Place of birth | Sydney New South Wales |
| Religion | Congregational |
| Occupation | Sanitary inspector |
| Address | Petersham, New South Wales |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs Elizabeth Blake, 'Chellas', 75 John Street, Petersham, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Australian Camel Field Ambulance |
| AWM Embarkation Roll number | 26/60/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A42 Boorara on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 7th Sanitation Section |
| Recommendations (Medals and Awards) |
Unspecified |
| Fate | Returned to Australia |