| Regimental number | 4054 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Hairdresser |
| Address | Waltham Stanley Street, Burwood, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs J G H Atkins c/o Miss Hunter, Waltham Stanley Street, Burwood, Sydney, New South Wales |
| Enlistment date | 24 October 1915 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Star Of England on 8 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps Details |
| Fate | Returned to Australia 7 June 1918 |
