| Regimental number | 12664 |
| Place of birth | Hackney South Australia |
| Religion | Church of England |
| Occupation | Porter, S A R |
| Address | Murray Park, Magill, S A |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs R Roberts, Coonalpyn Head Station, Culburra, South Australia |
| Enlistment date | 5 February 1916 |
| Rank on enlistment | Driver |
| Unit name | 11th Field Ambulance |
| AWM Embarkation Roll number | 26/54/1 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A29 Suevic on 31 May 1916 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 11th Field Ambulance |
| Fate | Effective abroad (still overseas) |
