| Regimental number | 12816 |
| Place of birth | Adelaide South Australia |
| Religion | Methodist |
| Occupation | Blacksmith |
| Address | 37 Rose Street, Mile End, South Australia |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs E A Roberts, 37 Rose Street, Mile End, South Australia |
| Previous military service | 77th Infantry |
| Enlistment date | 17 February 1916 |
| Rank on enlistment | Private |
| 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 | Lance Corporal |
| Unit from Nominal Roll | 11th Field Ambulance |
| Fate | Returned to Australia 23 June 1919 |
