| Regimental number | 1142 |
| Place of birth | Parkside South Australia |
| Religion | Church of England |
| Occupation | Fitter and turner |
| Address | Black Forest, South Australia |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mrs Christina Hepburn Impett, Black Forest, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Stationary Hospital 1 |
| AWM Embarkation Roll number | 26/70/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A55 Kyarra on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Casualty Clearing Station |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
