| Regimental number | 6099 |
| Religion | Methodist |
| Occupation | Moulder |
| Address | Crystal Brook, South Australia |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs E Roberts, Crystal Brook, South Australia |
| Enlistment date | 1 June 1915 |
| Rank on enlistment | Private |
| Unit name | 1 Australian General Hospital 1-6 Special Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 11 October 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Casualty Clearing Station |
| Fate | Returned to Australia 3 May 1919 |