| Religion | Church of England |
| Occupation | Medical practitioner |
| Address | Killara, New South Wales |
| Marital status | Married |
| Age at embarkation | 41 |
| Next of kin | Wife, Mrs N E Stacy, c/o W M Cameron, South Bend, Killara, New South Wales |
| Enlistment date | 29 September 1915 |
| Rank on enlistment | Lieutenant-Colonel |
| Unit name | 2nd Casualty Clearing Station |
| AWM Embarkation Roll number | 26/103/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A41 Bakara on 8 November 1915 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A62 Wandilla on 9 November 1915 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A39 Port Macquarie on 16 November 1915 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A34 Persic on 22 November 1915 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A40 Ceramic on 23 November 1915 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A59 Botanist on 24 November 1915 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A45 Bulla on 25 November 1915 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A23 Suffolk on 30 November 1915 |
| Rank from Nominal Roll | Lieutenant-Colonel |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia 4 May 1917 |
| Miscellaneous details (Nominal Roll) | *Second entry both matched |
