| Regimental number | 21821 |
| Place of birth | Ballarat, Victoria |
| Religion | Roman Catholic |
| Occupation | Dental operator |
| Address | Hackney, South Australia |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Mother, Wife address unknown, Mrs J Bourke, 38 Finlayson Street, Malvern, Victoria |
| Enlistment date | 11 October 1918 |
| Rank on enlistment | Staff Sergeant |
| Unit name | Dental Details |
| AWM Embarkation Roll number | 26/105/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic Recalled on 2 November 1918 |
| Fate | No details of fate entered on Nominal Roll |
