| Regimental number | 12409 |
| Place of birth | Narraport Victoria |
| Religion | Presbyterian |
| Occupation | Farmer |
| Address | Narraport, via Birchip, Victoria |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Father, George Theobald, Birchip, Victoria |
| Enlistment date | |
| Rank on enlistment | Driver |
| Unit name | Field Ambulance 10 |
| AWM Embarkation Roll number | 26/53/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A54 Runic on |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 10th Field Ambulance |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |