| Regimental number | 104 |
| Place of birth | Melbourne Victoria |
| Religion | Church of England |
| Occupation | Cutter |
| Address | 84 Kent Street, Richmond, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | J J Glaisher, 84 Kent Street, Richmond, Victoria |
| Previous military service | 14th Australian Army Medical Corps |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 2nd Field Ambulance |
| AWM Embarkation Roll number | 26/45/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Casualty Clearing Station |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
