| Regimental number | 12653 |
| Place of birth | Wilmington South Australia |
| Religion | Methodist |
| Occupation | School teacher |
| Address | 'Tamai', Watson Avenue, Rose Park, South Australia |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs C P Nicholls, 'Tamai', Watson Avenue, Rose Park, South Australia |
| Enlistment date | 6 January 1916 |
| Rank on enlistment | Private |
| Unit name | 11th Field Ambulance |
| AWM Embarkation Roll number | 26/54/1 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A29 Suevic on 31 May 1916 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 11th Field Ambulance |
| Fate | Returned to Australia 10 April 1919 |
