| Regimental number | 9216 |
| Place of birth | Stratford England |
| Religion | Church of England |
| Occupation | Salesman |
| Address | Ocean House, Pittwater Road, Manly, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Mary Ann Valentine, Ocean House, Pittwater Road, Manly, New South Wales |
| Enlistment date | 4 July 1915 |
| Rank on enlistment | Corporal |
| 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 | Sergeant |
| Unit from Nominal Roll | 1st Australian Dermatological Hospital |
| Fate | Effective abroad (still overseas) |
