| Regimental number | 18789 |
| Place of birth | Prospect South Australia |
| Religion | Church of England |
| Occupation | Moulder |
| Address | Prospect, South Australia |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs E Venables, 28 Marion Place, Prospect, South Australia |
| Enlistment date | 14 July 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, August 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 22 December 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian General Base Depot |
| Fate | Effective abroad (still overseas) |
