| Regimental number | 9004 |
| Place of birth | Gosford New South Wales |
| Religion | Church of England |
| Occupation | Carpenter |
| Address | Warner's Estate, Wyong, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, William Watts, Warner's Estate, Wyong, New South Wales |
| Enlistment date | 15 July 1915 |
| Rank on enlistment | Private |
| Unit name | Infantry Brigade 4,Field Ambulance 5, Reinforcement 9 |
| AWM Embarkation Roll number | 26/48/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on 15 January 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Field Ambulance |
| Fate | Returned to Australia 30 January 1918 |
