| Regimental number | 16794 |
| Place of birth | Liverpool England |
| Religion | Church of England |
| Occupation | Farmer and cook |
| Address | Fremantle, Western Australia |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs E A Blythe, 10 Point Street, Fremantle, Western Australia |
| Enlistment date | 21 March 1916 |
| Date of enlistment from Nominal Roll | 20 March 1915 |
| Rank on enlistment | Private |
| Unit name | January 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A28 Miltiades on 29 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Field Ambulance |
| Fate | Returned to Australia 12 March 1918 |
