| Regimental number | 2962 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Commercial traveller |
| Address | 'St Leans', Evans and Gardyne Streets, Waverley, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs Amy Fabian Cooper, 'St Leans', Evans and Gardyne Streets, Waverley, Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 5th Field Ambulance |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A31 Ajana on |
| Regimental number from Nominal Roll | Commisioined |
| Rank from Nominal Roll | 2nd Lieutenant |
| Unit from Nominal Roll | Australian Flying Corps |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
