| Regimental number | 19104 |
| Place of birth | Kyneton, Victoria |
| Religion | Presbyterian |
| Occupation | Salesman |
| Address | Surrey Hills, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs A Dougall, 8 Leopold Crescent, Surrey Hills, Victoria |
| Previous military service | 48th Infantry |
| Enlistment date | 25 June 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, September 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 22 December 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medcial Corps |
| Fate | Returned to Australia 14 December 1918 |
