| Regimental number | 209 |
| Place of birth | Warranbool |
| Religion | Church of England |
| Occupation | Tanner |
| Address | 72 Mary Smith, Preston, Victoria |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs J Smith, 72 Mary Smith, Preston, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 2nd Field Ambulance |
| AWM Embarkation Roll number | 26/45/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Field Ambulance |
| Fate | Returned to Australia |
| Miscellaneous information from cemetery records | Plaque in Victorian Garden of Remembrance |
| Date of death |