| Regimental number | 624 |
| Place of birth | Ferntree Gully, Victoria |
| Religion | Church of England |
| Occupation | No profession |
| Address | Bayswater, Victoria |
| Marital status | Married |
| Age at embarkation | 37 |
| Next of kin | Wife, Mrs A T Box, Coombe Cottage, Coldstream, Victoria |
| Enlistment date | 6 December 1914 |
| Rank on enlistment | Private |
| Unit name | 1st Field Ambulance, Reinforcement 1 |
| AWM Embarkation Roll number | 26/44/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A35 Berrima on 22 December 1914 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Field Ambulance |
| Fate | Returned to Australia 17 March 1917 |
