| Regimental number | 10133 |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Taggerty, Victoria |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Mother, Mrs C E Burt, 91 Winchester Road, St Margarets, Middlesex, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 1st Australian Casualty Clearing Station, 5th Reinforcement |
| AWM Embarkation Roll number | 26/103/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Orontes on |
| Miscellaneous details (Nominal Roll) | see other |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
