| Regimental number | 8176 |
| Religion | Church of England |
| Occupation | Bank clerk |
| Address | Traralgon, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs S Drewett, Hotham Street, Traralgon, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 1 Australian General Hospital 1-6 Special Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on |
| Miscellaneous details (Nominal Roll) | see other |