| Regimental number | 5763 |
| Place of birth | Sacunderabad India |
| Religion | Church of England |
| Occupation | Baker and cook |
| Address | Woomelang, Victoria |
| Marital status | Single |
| Age at embarkation | 44 |
| Next of kin | Friend, R S Jennings, Woomelang, Victoria |
| Enlistment date | 4 March 1916 |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/23/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A33 Ayrshire on 3 July 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
