| Religion | Church of England |
| Occupation | Farmer |
| Address | 172 Wittenoom Street, Perth, Western Australia |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs Mary Coombs, 172 Wittenoom Street, Perth, Western Australia |
| Enlistment date | 12 May 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps - Hospital Transports (Number 1 Hospital Ship A61, "Kanowna") |
| AWM Embarkation Roll number | 26/104/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A61 Kanowna on n.d. |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |