| Regimental number | 795 |
| Place of birth | Broken Hill New South Wales |
| Religion | Methodist |
| Occupation | Blacksmith |
| Address | Moonta, South Australia |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Sister, Miss D Coward, Moonta Mines, Moonta, South Australia |
| Enlistment date | 18 April 1917 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 8, Reinforcement 15 |
| AWM Embarkation Roll number | 24/13/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board SS Indarra on 26 November 1917 |
| Miscellaneous details (Nominal Roll) | missing page |
