| Regimental number | 8570 |
| Place of birth | Sydenham New South Wales |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Linden, Charles Street, Marrickville, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, A Witcombe, Linden, Charles Street, Marrickville, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | MED26.66.2R13 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |