| Regimental number | 17136 |
| Place of birth | Moonta South Australia |
| Religion | Baptist |
| Occupation | Dispenser |
| Address | Mannum, South Australia |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Father, J Vivian, Mannum, South Australia |
| Enlistment date | |
| Rank on enlistment | Staff Sergeant |
| Unit name | Staff Sergeant Dispensers |
| AWM Embarkation Roll number | 26/108/1 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A48 Seang Bee on |
| Rank from Nominal Roll | Staff Sergeant |
| Unit from Nominal Roll | Australian Army Medical Corps Details |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
