| Regimental number | 13658 |
| Place of birth | Brisbane Queensland |
| Religion | Baptist |
| Occupation | Plumber |
| Address | Wooloowin, Queensland |
| Marital status | Married |
| Age at embarkation | 27 |
| Next of kin | Wife, Mrs G C Sullivan, c/o Mrs C Ritchie, Riverton Street, Clayfield, Queensland |
| Enlistment date | 18 October 1915 |
| Date of enlistment from Nominal Roll | 10 March 1916 |
| 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 29 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Australian General Hospital |
| Fate | Returned to Australia 27 September 1917 |
