| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Medical practitioner |
| Address | Ballarat, Victoria |
| Age at embarkation | 49 |
| Next of kin | Wife, Mrs E B Champion, 16 Victoria Street, Ballarat, Victoria |
| Enlistment date | |
| Rank on enlistment | Captain |
| Unit name | Medical Officers |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A30 Borda on |
| Fate | No details of fate entered on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
