| Regimental number | 10179 |
| Place of birth | London England |
| Religion | Methodist |
| Occupation | Farmer |
| Address | South Gippsland, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Sister, Mrs M Swaine, 155 Miles Buildings, Linten Street, Edgeware Road, London, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | No. 3 Australian General Hospital, 1st Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A23 Suffolk on |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 15th Field Ambulance |
| Recommendations (Medals and Awards) |
Military Medal Recommendation date: |
| Fate | Returned to Australia |