| Regimental number | 6866 |
| Occupation | Glass worker |
| Marital status | Single |
| Age at embarkation | 19 |
| 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 |