| Regimental number | 19135 |
| Place of birth | Milton Queensland |
| Religion | Church of England |
| Occupation | Commercial traveller |
| Address | Hawthorn, Victoria |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | Wife, Mrs M J Willoughby, 20 Smart Street, Hawthorn, Victoria |
| Enlistment date | 12 May 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, September 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 22 December 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian General Hospital |
| Fate | Returned to Australia 6 September 1919 |