| Regimental number | 10058 |
| Place of birth | Charters Towers Queensland |
| Religion | Methodist |
| Occupation | Chemist's assistant |
| Address | c/o W H Green and Co, chemists, Townsville, Queensland |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs J H Chapman, c/o Mrs Redmond, Walker Street, West Townsville, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 7th Field Ambulance, 11th Reinforcements |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A16 Star of Victoria on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 14th Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
