| Regimental number | 21053 |
| Religion | Methodist |
| Occupation | Cook |
| Address | Abbotsford, New South Wales |
| Marital status | Married |
| Age at embarkation | 36 |
| Next of kin | Wife, Mrs C R Davis, 'Retlaw', Irene Street, Abbotsford, New South Wales |
| Enlistment date | 7 May 1918 |
| Date of enlistment from Nominal Roll | 19 December 1918 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Sea Transport Staff, Section 10 (Mental) |
| AWM Embarkation Roll number | 26/104/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 2 November 1918 |
| Regimental number from Nominal Roll | 21053 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | Sea Transport Staff |
| Fate | Returned to Australia 28 March 1919 |
