| Regimental number | 5097 |
| Place of birth | Johannesburg South Africa |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Wellington, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs E Raymond, Dist. Hospital, Wellington, New South Wales |
| Enlistment date | 13 January 1916 |
| Rank on enlistment | Private |
| Unit name | 18th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/35/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on 5 June 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps Details |
| Fate | Returned to Australia 30 January 1918 |
