| Regimental number | 19450 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Plasterer |
| Address | Bexley, New South Wales |
| Marital status | Married |
| Age at embarkation | 21 |
| Next of kin | Wife, Mrs I L Broadbridge, 'Revellie', Connemara Street, Bexley, New South Wales |
| Previous military service | 38th Infantry |
| Enlistment date | 23 July 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 | 3rd Australian General Hospital |
| Fate | Effective abroad (still overseas) |
