| Regimental number | 2603 |
| Place of birth | Brisbane Queensland |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Fifth Avenue, Sandgate, Queensland |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Edwin John Shaw, Fifth Avenue, Sandgate, Queensland |
| Enlistment date | 25 March 1915 |
| Rank on enlistment | PTE (Nurse) |
| Unit name | 4th Light Horse Field Ambulance |
| Embarkation details | Unit embarked from on board HMAT A30 Borda on 16 June 1915 |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | Australian Army Pay Corps |
| Fate | Effective abroad (still overseas) |
