| Regimental number | 17201 |
| Place of birth | Sussex England |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Queenstown, Tasmania |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs V R Wade, 'Werton', Woodbridge, Tasmania |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, March 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
