| Regimental number | 14611 |
| Place of birth | Rosewater South Australia |
| Religion | Church of England |
| Occupation | Carpenter |
| Address | Yatala, South Australia |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs M Jensen, Queen Street, Yatala, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Australian Army Medical Corps, July 1916 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A70 Ballarat on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Division Sanitation Section |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Centennial Park Cemetery |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
