| Regimental number | 21246 |
| Place of birth | Temora New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Sunbury, Victoria |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Sister, Miss E Anderson, 12 Alice Street, Yarraville, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Sea Transport Section |
| Fate | Effective abroad (still overseas) |