| Regimental number | 6863 |
| Place of birth | Sydney New South Wales |
| Occupation | Cook |
| Marital status | Married |
| Age at embarkation | 44 |
| Rank on enlistment | Private |
| Unit name | 24th Battalion 19th Reinforcement |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on |
| Miscellaneous details | Entry under construction |