| Regimental number | 4286 |
| Place of birth | Angaston South Australia |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Booleroo |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, Nicholas Fuller, Plympton, South Australia |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | Australian Stationary Hospital 2, Reinforcement 8 |
| AWM Embarkation Roll number | 26/71/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A68 Anchises on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Field Ambulance |
| Recommendations (Medals and Awards) |
Military Medal Steadiness, courage and high example while working as stretcher-bearer under heavy fire. Recommendation date: |
| Fate | Returned to Australia |
| Medals |
Military Medal Source: 'Commonwealth Gazette' No. 31 Date: |