| Date of birth | |
| Place of birth | Burnside, South Australia |
| School | St Peter's College, Adelaide, South Australia |
| Other training | University of Adelaide, South Australia |
| Religion | Church of England |
| Occupation | Medical practitioner |
| Address | Lower North Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs J H Black, Stanley Street, Lower North Adelaide, South Australia |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Captain |
| Unit name | Medical Officers |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A24 Benalla on |
| Rank from Nominal Roll | Captain |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Effective abroad (still overseas) |
| Other details | War service: France, Belgium. Gassed, Passchendaele, 28 October 1917. arrived back in Australia, 13 December 1919. |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
