| Regimental number | 1215 |
| Place of birth | South Shields England |
| Religion | Church of England |
| Occupation | Patternmaker |
| Address | 15 Elyde Street, East Fremantle, Western Australia |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, W Clark, 33 Broughton Road, South Shields, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Australian Stationary Hospital 2 |
| AWM Embarkation Roll number | 26/71/1 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board Transport A55 Kyarra on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
