| Regimental number | 12272 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Motor mechanic |
| Address | Hay, New South Wales |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs M R Clark, 96 Coborn Road, Bow, London E, England |
| Enlistment date | |
| Rank on enlistment | Sergeant |
| Unit name | Field Ambulance 10 |
| AWM Embarkation Roll number | 26/53/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A54 Runic on |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 1st Mechanical Transport Company |
| Recommendations (Medals and Awards) |
Military Medal Recommendation date: |
| Fate | Returned to Australia |
| Medals |
Military Medal Source: 'Commonwealth Gazette' No. 219 Date: |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
