| Regimental number | 13649 |
| Place of birth | Goulburn New South Wales |
| Religion | Roman Catholic |
| Occupation | Wardsman |
| Address | Lismore, New South Wales |
| Marital status | Married |
| Age at embarkation | 31 |
| Next of kin | Wife, Mrs A South, 34 Cleveland Street, Darlington, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps Details |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
