| Regimental number | 786 |
| Religion | Church of England |
| Occupation | Miner |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs Elizabeth Childs, 11 Stanley Road, Southwell-on-Sea |
| Enlistment date | 10 November 1914 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps - Hospital Transports (Number 1 Hospital Ship A61, "Kanowna") |
| AWM Embarkation Roll number | 26/104/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A61 Kanowna on n.d. |
| Miscellaneous details (Nominal Roll) | see other |
