| Regimental number | 4369 |
| Religion | Church of England |
| Occupation | Printer |
| Address | Orange, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs M J Dein, 59 Lords Place, Orange, New South Wales |
| Previous military service | 42nd Infantry |
| Enlistment date | 15 April 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Australian General Hospital |
| AWM Embarkation Roll number | 26/67/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on 15 May 1915 |
| Miscellaneous details (Nominal Roll) | see other |
