| Regimental number | 4870 |
| Religion | Roman Catholic |
| Occupation | Blacksmith |
| Address | 501 Edmund Street, Beaconsfield, Fremantle, Western Australia |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs Emily Mary Shaw, 501 Edmund Street, Beaconsfield, Fremantle, Western Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 1st Australian General Hospital, Special Reinforcements (Hospital and Convalescent Home) |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A62 Wandilla on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Australian Auxiliary Hospital |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
