| Regimental number | 13863 |
| Place of birth | Gravesend England |
| Religion | Church of England |
| Occupation | Hospital attendant |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Sister, Mrs C Clinch, 32 Alexandria Road, Norton next Gravesend, England |
| Enlistment date | 15 December 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on 29 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia 30 April 1919 |