| Regimental number | 13339 |
| Place of birth | Gale Victoria |
| Religion | Methodist |
| Occupation | Home missionary |
| Address | Daylesford, Victoria |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, Rev D Provan, Daylesford, Victoria |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A63 Karoola on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
