| Regimental number | 16710 |
| Place of birth | Glenferrie, Victoria |
| Religion | Presbyterian |
| Occupation | Telephone mechanic |
| Address | 7 Taylor Street, Moonee Ponds, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, Albert Cohen, 7 Taylor Street, Moonee Ponds, Victoria |
| Enlistment date | 31 December 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Light Horse Field Ambulance, 25th Reinforcement |
| AWM Embarkation Roll number | 26/41/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Karmala on 6 February 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
