| Occupation | Medical practitioner |
| Address | 'Suma', Orange, New South Wales |
| Marital status | Married |
| Age at embarkation | 50 |
| Next of kin | Wife, Mrs Evelyn House, 'Suma', Orange, New South Wales |
| Previous military service | Reserve of Officers |
| Enlistment date | |
| Rank on enlistment | Lieutenant-Colonel |
| Unit name | Head Quarters 1st Australian Division |
| AWM Embarkation Roll number | 1/42/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A3 Orvieto on |
| Date of embarkation incorrectly entered on Embarkation Roll as 22 October 1914. | |
| Miscellaneous details (Nominal Roll) | No details of fate entered on Nominal Roll. |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
