| Regimental number | 9836 |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | 172 Wittenoom Street, East Perth, Western Australia |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs C Davy, 172 Wittenoom Street, East Perth, Western Australia |
| Enlistment date | 15 May 1916 |
| Rank on enlistment | Private |
| Unit name | Field Ambulance 4, Reinforcement 16 |
| AWM Embarkation Roll number | 26/47/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A9 Shropshire on 31 March 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |