| Regimental number | 13177 |
| Place of birth | Narrandera New South Wales |
| Religion | Church of England |
| Occupation | Bootmaker |
| Address | East Fremantle, Western Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs M L Phillips, 33 East Street, East Fremantle, Western Australia |
| Enlistment date | 1 February 1916 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A63 Karoola on 14 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia 28 March 1919 |
