| Religion | Congregational |
| Occupation | Dentist |
| Address | Croydon, New South Wales |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Father, J Douglass, 'Oraki', Liverpool Road, Croydon, New South Wales |
| Previous military service | Australian Army Medical Corps Res |
| Enlistment date | 13 February 1916 |
| Rank on enlistment | HON LT |
| Unit name | Dental Details |
| AWM Embarkation Roll number | 26/105/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on 3 June 1916 |
| Rank from Nominal Roll | Captain |
| Unit from Nominal Roll | Dental Corps |
| Fate | Returned to Australia 8 January 1919 |
