| Regimental number | 13734 |
| Date of birth | |
| Place of birth | London, England |
| Religion | Church of England |
| Occupation | Hospital attendant |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs E S Adams, 3 Lutton Terrace, Flask Walk, Hampstead, London, England |
| Enlistment date | |
| Place of enlistment | Goulburn, New South Wales |
| 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 | 17th Field Ambulance |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |
| Date of death | |
| Age at death | 72 |
| Place of burial | Goulburn Cemetery, New South Wales |