| Regimental number | 19409 |
| Place of birth | Gatton Queensland |
| Religion | Seventh Day Adventist |
| Occupation | School teacher |
| Address | Gatton, Queensland |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs A Bernoth, Lower Tent Hill, Gatton, Queensland |
| Enlistment date | 4 September 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A41 Bakara on 4 September 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia 22 August 1919 |
