| Regimental number | 4497 |
| Address | 93 Wellington Road, Wanstead, London |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs Alice Mary Bushell, 93 Wellington Road, Wanstead, London |
| Enlistment date | 11 May 1915 |
| Date of enlistment from Nominal Roll | 9 May 1915 |
| Rank on enlistment | Private |
| Unit name | No 3 Australian General Hospital |
| AWM Embarkation Roll number | 26/67/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on 15 May 1915 |
| Rank from Nominal Roll | Lieutenant |
| Unit from Nominal Roll | 18th Battalion |
| Fate | Discharged 13 October 1919 |