| Regimental number | 17 |
| Place of birth | Rockhampton Queensland |
| Religion | Church of England |
| Occupation | Brushmaker |
| Address | Newcombe Street, Sans Souci, Kogarah, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Foster Mother, Mrs W F Lewis, Newcombe Street, Sans Souci, Kogarah, New South Wales |
| Enlistment date | |
| Rank on enlistment | Driver |
| Unit name | 1st Light Horse Field Ambulance, A Squadron |
| AWM Embarkation Roll number | 26/39/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board Transport A27 Southern on |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 4th Field Ambulance |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Allambe Gdns Cemetery |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
