| Regimental number | 6427 |
| Place of birth | Encounter Bay, South Australia |
| Religion | Church of Christ |
| Occupation | Shunter |
| Address | Encounter Bay, South Australia |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs E E Bolger, Encounter Bay, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Field Ambulance 4, Reinforcement 12 |
| AWM Embarkation Roll number | 26/47/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board TRANSPORT HMS Malwa on |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 12th Field Ambulance |
| Recommendations (Medals and Awards) |
Military Medal Recommendation date: |
| Fate | Effective abroad (still overseas) |