| Regimental number | 19693 |
| Place of birth | Adelaide South Australia |
| Religion | Plymouth Brethren |
| Occupation | Storekeeper |
| Address | Cronulla, New South Wales |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs M M Southwell, Buranur Bay Road, Cronulla, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Carpentaria on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Light Horse Regiment |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
