| Regimental number | 1876 |
| Occupation | ... |
| Address | ... |
| Marital status | Single |
| Age at embarkation | ... |
| Next of kin | ..., ... |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 14th Battalion, 4th Reinforcement |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A9 Shropshire on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 14th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
