| Regimental number | 21256 |
| Place of birth | Richmond Victoria |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Footscray, Victoria |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Father, P C Neilsen, 20 Robert Street, Footscray, Victoria |
| Previous military service | 53rd Infantry |
| Enlistment date | 6 May 1918 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Sea Transport Staff |
| Fate | Effective abroad (still overseas) |
