| Regimental number | 4291 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Surgeon dentist |
| Address | Parkes Street, Ryde, New South Wales |
| Marital status | Single |
| Age at embarkation | 36 |
| Next of kin | Father, M Nancarrow, Beaconsfield, Ryde, New South Wales |
| Enlistment date | 22 September 1915 |
| Rank on enlistment | Private |
| Unit name | 18th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/35/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Star Of England on 8 March 1916 |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | Dental Unit |
| Fate | Returned to Australia 2 June 1919 |
