| Regimental number | 21244 |
| Religion | Church of England |
| Occupation | Cook |
| Address | South Brunswick, Victoria |
| Marital status | Married |
| Age at embarkation | 40 |
| Next of kin | Wife, Mrs A Adams, 21 Watson Street, South Brunswick, Victoria |
| Enlistment date | 1 May 1918 |
| Rank on enlistment | Private |
| Unit name | Hospital Transport Corps |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board No 2 Hospital Ship Kanowna on 25 September 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian Hospital Service |
| Fate | Effective abroad (still overseas) |