| Regimental number | 17360 |
| Place of birth | Melbourne Victoria |
| Religion | Church of England |
| Occupation | Despatch clerk |
| Address | Port Melbourne, Victoria |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs D M Smith, 87 Station Street, Port Melbourne, Victoria |
| Enlistment date | 4 May 1916 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps February 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on 11 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Field Ambulance |
| Fate | Effective abroad (still overseas) |
