
| Regimental number | 9957 |
| Religion | Church of England |
| Occupation | Station employee |
| Marital status | Single |
| Age at embarkation | 43 |
| Next of kin | Sister, Miss S E Davies, Upper Mount, Southsea, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 2nd Australian General Hospital, 16th Reinforcement |
| AWM Embarkation Roll number | 26/66/3 |
| Miscellaneous details (Nominal Roll) | see other |