| Regimental number | 17404 |
| Place of birth | Kapunda, South Australia |
| Religion | Congregational |
| Occupation | Cook |
| Address | Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs K Brown, 225 Flinders Street, Adelaide, South Australia |
| Enlistment date | 2 October 1916 |
| 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 | 11th Field Ambulance |
| Fate | Returned to Australia 7 July 1919 |
| Date of death | 21 April 1961 |
| Place of burial | Centennial Park Cemetery |
