| Regimental number | 36 |
| Place of birth | Toowoomba Queensland |
| Religion | Church of England |
| Occupation | Pastrycook |
| Address | Delacey Street, Toowoomba, Queensland |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | M Stokan, Delacey Street, Toowoomba, Queensland |
| Previous military service | 24th Australian Army Medical Corps |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 3rd Field Ambulance, A Squadron |
| AWM Embarkation Roll number | 26/46/1 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board Transport A22 Rangatira on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
