| Regimental number | 9957 |
| Place of birth | Liverpool England |
| Religion | Church of England |
| Occupation | Station employee |
| Address | Upper Mount, South Sea, England |
| Marital status | Single |
| Age at embarkation | 43 |
| Next of kin | Sister, S E Davies, Upper Mount, South Sea, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 2nd Australian General Hospital, 16th Reinforcement |
| AWM Embarkation Roll number | 26/66/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A16 Star of Victoria on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Field Ambulance |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |