| Regimental number | 1763 |
| Religion | Church of England |
| Occupation | Fireman |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Guardian, Mrs T E Oakes, 50 Creswell Street, Kings Lynn, England |
| Enlistment date | 13 January 1915 |
| Rank on enlistment | Private |
| Unit name | 1 Australian General Hospital 1-6 Special Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 11 October 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian General Hospital |
| Fate | Returned to Australia 9 February 1916 |
| Miscellaneous details (Nominal Roll) | *Second entry both matched |
