| Regimental number | 8236 |
| Religion | Methodist |
| Occupation | Upholsterer |
| Address | Benalla, Victoria |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Father, S Clay, 15 Johns Road, Penge, London, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 1 Australian General Hospital 1-6 Special Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on |
| Miscellaneous details (Nominal Roll) | see other |