| Regimental number | 21769 |
| Place of birth | Abbotsford Victoria |
| Religion | Roman Catholic |
| Occupation | Tailor's presser |
| Address | Elsternwick, Victoria |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Father, H R Smith, 27 Regent Street, Elsternwick, Victoria |
| Enlistment date | 7 May 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian General Hospital |
| Fate | Returned to Australia 13 July 1919 |
