| Regimental number | 14509 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Station hand |
| Address | 39 Mansfield Road, Hampstead, London |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, Charles Lewis, 39 Mansfield Road, Hampstead, London |
| Enlistment date | 22 December 1915 |
| Rank on enlistment | Private |
| Unit name | 1st Light Horse Field Ambulance, 20th Reinforcement |
| AWM Embarkation Roll number | 26/39/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Malwa on 22 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Stationary Hospital |
| Fate | Returned to Australia 15 June 1919 |
