| Regimental number | 4343 |
| Religion | Church of England |
| Occupation | Naval staff clerk |
| Address | Canterbury, New South Wales |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs S E Boutcher, Waterford, Minter Street, Canterbury, New South Wales |
| Previous military service | 40th Australian Army Medical Corps |
| Enlistment date | 27 April 1915 |
| Rank on enlistment | LSGT |
| Unit name | 3rd Australian General Hospital |
| AWM Embarkation Roll number | 26/67/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on 15 May 1915 |
| Miscellaneous details (Nominal Roll) | see other |
