| Regimental number | 13836 |
| Place of birth | Thames New Zealand |
| Religion | Methodist |
| Occupation | Mechanical engineer |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs E Rose, Richmond Street, Shortland, Thames, New Zealand |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Casualty Clearing Station |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
