| Regimental number | 4051 |
| Place of birth | Queanbeyan New South Wales |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Barracks Flat, Queanbeyan |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs Philadephia Fitzgibbons, Barracks Flat, Queanbeyan |
| Enlistment date | 13 April 1915 |
| Rank on enlistment | Private |
| Unit name | 1st Light Horse Field Ambulance, 6th Reinforcement |
| AWM Embarkation Roll number | 26/39/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A65 Clan Mcewan on 28 May 1915 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 5th Light Horse Ambluance |
