| Regimental number | 21862 |
| Place of birth | Eagle Hawk, Victoria |
| Religion | Methodist |
| Occupation | Dental mechanic |
| Address | Middle Park, Victoria |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs S E Evans, 37 Armstrong Street, Middle Park, Victoria |
| Enlistment date | 28 September 1918 |
| Rank on enlistment | Staff Sergeant |
| Unit name | Dental Details |
| AWM Embarkation Roll number | 26/105/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic Recalled on 2 November 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
