| Regimental number | 19775 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Waverley, New South Wales |
| Marital status | Married |
| Age at embarkation | 27 |
| Next of kin | Wife, Mrs I C M Watts, 'Roma', Varna Street, Waverley, New South Wales |
| Enlistment date | 14 September 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A36 Boonah on 29 October 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | General Reinforcements, Australian Army Medical Corps |
| Fate | Returned to Australia 3 September 1919 |
