| Regimental number | 6029 |
| Religion | Church of England |
| Occupation | Hospital attendant |
| Address | Parramatta, New South Wales |
| Marital status | Married |
| Age at embarkation | 27 |
| Next of kin | Wife, Mrs L R Couper, c/o Mrs E Couper, George Street, Parramatta, New South Wales |
| Enlistment date | 21 May 1915 |
| Rank on enlistment | Private |
| Unit name | 1 Australian General Hospital 1-6 Special Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 11 October 1915 |
| Miscellaneous details (Nominal Roll) | see other |