| Regimental number | 9217 |
| Place of birth | Stratford England |
| Religion | Church of England |
| Occupation | Estate agent |
| Address | Ocean House, Pittwater Road, Manly, New South Wales |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs Mary Ann Valentine, Ocean House, Pittwater Road, Manly, New South Wales |
| Enlistment date | 4 July 1915 |
| Rank on enlistment | Private |
| Unit name | Dermatological Hospital |
| AWM Embarkation Roll number | 26/69/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on 22 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Casualty Clearing Station |
| Fate | Returned to Australia 12 May 1919 |
