| Regimental number | 16921 |
| Place of birth | South Yarra, Victoria |
| Religion | Presbyterian |
| Occupation | Carpenter |
| Address | Elsternwick, Victoria |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs Lillian May Boulter, Parkside Street, Elsternwick, Victoria |
| Previous military service | 13th A A S C |
| Enlistment date | 19 April 1916 |
| Rank on enlistment | Private |
| Unit name | Australian Camel Field Ambulance |
| AWM Embarkation Roll number | 26/60/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A42 Boorara on 10 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Light Horse Field Ambulance |
| Fate | Returned to Australia 26 January 1919 |
