| Regimental number | 1121 |
| Place of birth | Adelaide, South Australia |
| Religion | Church of England |
| Occupation | Engine driver |
| Address | Avenue Road, Prospect, South Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, Geo Clark, Avenue Road, Prospect, South Australia |
| Enlistment date | 29 September 1914 |
| Rank on enlistment | Private |
| Unit name | Stationary Hospital 1 |
| AWM Embarkation Roll number | 26/70/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A55 Kyarra on 5 December 1914 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Australian Auxiliary Hospital |
| Fate | Returned to Australia 4 May 1917 |
| Date of death | 11 September 1967 |
| Place of burial | Centennial Park Cemetery |
