| Regimental number | 6036 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Compositor |
| Address | 19 Brook Street, North Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | Wife, Mrs Florence Amelia Boughtwood, 19 Brook Street, North Sydney, New South Wales |
| Enlistment date | 28 June 1916 |
| Date of enlistment from Nominal Roll | 14 June 1916 |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/36/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A11 Ascanius on 25 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia 18 July 1919 |