| Regimental number | 8063 |
| Religion | Church of England |
| Occupation | Hospital attendant |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Father, W T Ellis, Kirkby, Lonsdale, Westmoreland, England |
| 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) | Name does not appear on Nominal Roll |