| Regimental number | 17246 |
| Place of birth | Marburg Queensland |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Yandina, Queensland |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs K Staats, Murwillumbah, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, March 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A20 Hororata on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
