| Regimental number | 13606 |
| Place of birth | Collarenebri New South Wales |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Grafton, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs P Clark, Commercial Hotel, Prince Street, Grafton, New South Wales |
| Enlistment date | 24 September 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on 29 March 1916 |
| Miscellaneous details (Nominal Roll) | see other |
