| Regimental number | 4346 |
| Religion | Roman Catholic |
| Occupation | Engineer fitter |
| Address | Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Sister, Mrs J Defosses, Sonnilae, Mauritius |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 3rd Australian General Hospital |
| AWM Embarkation Roll number | 26/67/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on |
| Miscellaneous details (Nominal Roll) | see other |