| Regimental number | 20574 |
| Place of birth | Adelaide South Australia |
| Religion | Church of England |
| Occupation | Motorman |
| Address | Torrensville, South Australia |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs L L Wallis, Hardy's Road, Torrensville, South Australia |
| Enlistment date | 5 November 1917 |
| Date of enlistment from Nominal Roll | 15 November 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Effective abroad (still overseas) |
