| Regimental number | 6904 |
| Place of birth | Birmingham, England |
| Occupation | Driver |
| Marital status | Single |
| Age at embarkation | 24 |
| Place of enlistment | Melbourne, Victoria |
| 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 |