| Regimental number | 16963 |
| Place of birth | Moonta, Victoria |
| Religion | New Thought |
| Occupation | Telegraph mechanic |
| Address | Hyde Park, South Australia |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, John James Broad, 93 King William Road, Hyde Park, South Australia |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | Australian Camel Field Ambulance Reinforcement 1 |
| AWM Embarkation Roll number | 26/60/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A42 Boorara on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Light Horse Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
