| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Medical practitioner |
| Address | Mosman, New South Wales |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Mother, Mrs E M Clark, 23 Bedford Gardens, Kensington, London, W England |
| Enlistment date | 1 December 1916 |
| Rank on enlistment | Captain |
| Unit name | Medical Officers |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A26 Armadale on 3 March 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
