| Regimental number | 1616 |
| Place of birth | Lismore New South Wales |
| Religion | Methodist |
| Occupation | Grocer |
| Address | Ekibin, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs W H Tavener, Chester Road, Ekibin, Brisbane, Queensland |
| Enlistment date | 4 May 1915 |
| Rank on enlistment | Private |
| Unit name | No 1 Australian General Hospital |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board A62 Wandilla on 25 June 1915 |
| Regimental number from Nominal Roll | 1616A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian General Hospital |
| Fate | Returned to Australia 6 September 1919 |
