| Regimental number | 68905 |
| Place of birth | Lao Ho Kow China |
| Religion | Baptist |
| Occupation | Clerk |
| Address | Hawthorn, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, O Burgess, China Inland Mission, Luanfu Shansi, China |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 15th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A36 Boonah on |