| Regimental number | 17403 |
| Place of birth | London England |
| Religion | Roman Catholic |
| Occupation | Platelayer |
| Address | Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 40 |
| Next of kin | Sister, Miss E Brooks, 5 Wagner Street, Canterbury Road, Old Kent Road, London, England |
| Enlistment date | 8 March 1917 |
| Date of enlistment from Nominal Roll | 31 March 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, March 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A30 Borda on 23 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Field Ambulance |
| Fate | Discharged 1 February 1919 |
