| Regimental number | 4787 |
| Place of birth | Chang-hai China |
| Religion | Church of England |
| Occupation | Electrical engineer |
| Address | Miss E J Warren, Church Terrace, Walkerville, South Australia |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs Lily Woodley, Daitoti, Formosa, Japan |
| Enlistment date | 17 May 1915 |
| Rank on enlistment | Private |
| Unit name | Australian General Hospital 3, Reinforcement 1 |
| AWM Embarkation Roll number | 26/67/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A62 Wandilla on 15 June 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Australian General Hospital |
| Fate | Discharged 9 January 1916 |
