| Regimental number | 21077 |
| Place of birth | Durham England |
| Religion | Church of England |
| Occupation | Quarryman |
| Address | Banksia, New South Wales |
| Marital status | Married |
| Age at embarkation | 52 |
| Next of kin | Wife, Mrs E Thew, 'Rodendo', Judd Street, Banksia, New South Wales |
| Enlistment date | 25 October 1918 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Sea Transport Staff, Section 10 (Mental) |
| AWM Embarkation Roll number | 26/104/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 2 November 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
