| Regimental number | 7675 |
| Place of birth | Hawthorn, Victoria |
| Religion | Church of England |
| Occupation | Clerk |
| Address | 'Luccombe', Tennyson Street, St Kilda, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, Frederick G D'Ombrain, 'Luccombe', Tennyson Street, St Kilda, Victoria |
| Enlistment date | 7 April 1915 |
| Rank on enlistment | Private |
| Unit name | Australian General Hospital 3, Reinforcement 2 |
| AWM Embarkation Roll number | 26/67/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A20 Hororata on 27 September 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
