| Regimental number | 12377 |
| Place of birth | Brighton Victoria |
| Religion | Church of England |
| Occupation | Cinematograph operator |
| Address | 121 Athol Street, Moonee Ponds, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Mabel B Blake, 121 Athol Street, Moonee Ponds, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Field Ambulance 10 |
| AWM Embarkation Roll number | 26/53/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A54 Runic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 8th Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
