| Regimental number | 4779 |
| Religion | Methodist |
| Occupation | Miner |
| Address | c/o Mrs E A Thomas, Chatham Street off Sturt Street, Adelaide, South Australia |
| Marital status | Married |
| Age at embarkation | 33 |
| Next of kin | Wife, Mrs Elizabeth Ann Thomas, Chatham Street off Sturt Street, Adelaide, South Australia |
| Enlistment date | 17 April 1915 |
| Rank on enlistment | Private |
| Unit name | Australian General Hospital 3, Reinforcement 1 |
| AWM Embarkation Roll number | 26/67/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A62 Wandilla on 15 June 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
