| Regimental number | 8167 |
| Religion | Church of England |
| Occupation | Mfb fireman |
| Address | Hawksburn, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Sister, Mrs J W Jones, 17 Clack Street, Hawksburn, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 1 Australian General Hospital 1-6 Special Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on |
| Miscellaneous details (Nominal Roll) | see other |