| Regimental number | 656 |
| Place of birth | Coolah New South Wales |
| Religion | Church of England |
| Occupation | Wardsman, hospital |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs Susan Cook, Coolah PO, Coolah, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Australian General Hospital 2 |
| AWM Embarkation Roll number | 26/66/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board Transport A55 Kyarra on |
| Regimental number from Nominal Roll | 66294 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps Details |
| Miscellaneous details (Nominal Roll) | No details of fate on Nominal Roll |
| Other details |
Re-enlisted, 11 June 1918, as 66294 Private, New South Wales Reinforcement 20; embarked at Melbourne on SS 'Zealandic' on 5 October 1918. Medals: 1914-15 Star, British War Medal, Victory Medal |