| Regimental number | 13160 |
| Place of birth | Perth, Western Australia |
| Religion | Church of England |
| Occupation | Hospital orderly |
| Address | West Midland, Western Australia |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs M Cook, Archer Street, West Midland, Western Australia |
| Enlistment date | 12 January 1916 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A63 Karoola on 14 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Australian General Hospital |
| Fate | Returned to Australia 22 December 1918 |
