| Place of birth | Newcastle New South Wales |
| Religion | Church of England |
| Occupation | Medical practitioner |
| Address | Strathfield, New South Wales |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Father, J B Clark, Hazel Dell, Boulevarde, Strathfield, New South Wales |
| Previous military service | A A M C Reserve |
| Enlistment date | 29 January 1918 |
| Rank on enlistment | Captain |
| Unit name | Medical Officers |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 1 August 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
