| Regimental number | 10437 |
| Place of birth | Brisbane Queensland |
| Religion | Congregational |
| Occupation | Dental student |
| Address | Chatswood, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, E Blackwell, 'Lingwood', Finlay Avenue, Chatswood, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Staff Sergeant |
| Unit name | Dental Details |
| AWM Embarkation Roll number | 26/105/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on |
| Rank from Nominal Roll | Staff Sergeant |
| Unit from Nominal Roll | 18th Dental Corps |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
