| Regimental number | 13603 |
| Place of birth | Ipswich Queensland |
| Religion | Baptist |
| Occupation | Packer |
| Address | Teneriffe, Queensland |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs M A Cook, Arthur Street, Teneriffe, Queensland |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 14th Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
