| Regimental number | 12253 |
| Place of birth | Trentham, Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Trentham, Victoria |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs Mary Broad, Post Office Trentham, Trentham, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Field Ambulance 10 |
| AWM Embarkation Roll number | 26/53/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A54 Runic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
