| Regimental number | *128 |
| Religion | Church of England |
| Occupation | Caretaker |
| Address | 20 Gore Street, Fitzroy, Melbourne, Victoria |
| Marital status | Married |
| Age at embarkation | 40 |
| Next of kin | Wife, Mrs Mary Falconer, 20 Gore Street, Fitzroy, Melbourne, Victoria |
| Enlistment date | 10 November 1914 |
| Rank on enlistment | Private |
| Unit name | 1 Australian General Hospital (November 1914) |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board Transport A55 Kyarra on 21 November 1914 |
| Regimental number from Nominal Roll | 128 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 1st Australian General Hospital |
| Fate | Returned to Australia 5 July 1915 |
