| Regimental number | 4870 |
| Religion | Roman Catholic |
| Occupation | Blacksmith |
| Address | Fremantle, Western Australia |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs E M Shaw, 501 Edmund Street, Beaconsfield, Fremantle, Western Australia |
| Enlistment date | 20 May 1915 |
| Rank on enlistment | Private |
| Unit name | No 1 Australian General Hospital |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board A62 Wandilla on 25 June 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Australian Auxiliary Hospital |
| Fate | Returned to Australia 19 April 1919 |
| Miscellaneous details (Nominal Roll) | *Second entry both matched |
