| Regimental number | 4686 |
| Religion | Methodist |
| Occupation | Ironmoulder |
| Marital status | Married |
| Age at embarkation | 33 |
| Next of kin | Wife, Mrs Evelyn Church, 10 Hobson Street, Newport, Melbourne, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 21st Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/38/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A14 Euripides on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
