| Regimental number | 1361 |
| Religion | Church of England |
| Occupation | Labourer |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Henry Cotterell, 16 Meadow Cottages, Congleton, Cheshire, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Field Ambulance 4, Section C |
| AWM Embarkation Roll number | 26/47/1 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board Transport A31 Ajana on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
| Medals |
Military Medal Source: 'Commonwealth Gazette' No. 115 Date: |