| Regimental number | 17152 |
| Place of birth | Broken Hill New South Wales |
| Religion | Roman Catholic |
| Occupation | Railway porter |
| Address | Terowie, South Australia |
| Marital status | Married |
| Age at embarkation | 22 |
| Next of kin | Wife, Mrs M E Waters, Terowie, South Australia |
| Enlistment date | 24 July 1916 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps February 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A30 Borda on 23 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 14th Field Ambulance |
| Fate | Returned to Australia 13 July 1919 |
