| Regimental number | 4214 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Bread carter |
| Address | Gipps Street, Concord, New South Wales |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs M Clissold, Gipps Street, Concord, New South Wales |
| Enlistment date | 18 April 1915 |
| Rank on enlistment | Private |
| Unit name | 1st Field Ambulance 8th Reinforcements |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board H.M.A.T. A54 Runic on 9 August 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 14th Field Ambulance |
| Fate | Returned to Australia 23 March 1919 |
