| Regimental number | 20535 |
| Place of birth | Kent Town, South Australia |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Rose Park, South Australia |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs E Adam, Alexandra Avenue, Rose Park, South Australia |
| Enlistment date | 28 December 1917 |
| Place of enlistment | Adelaide, South Australia |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Effective abroad (still overseas) |
