| Regimental number | 21775 |
| Place of birth | Northampton, England |
| Religion | Church of England |
| Occupation | Boot trade |
| Address | West Richmond, Victoria |
| Marital status | Married |
| Age at embarkation | 24 |
| Next of kin | Wife, Mrs E M Wods, 6 New Street, West Richmond, Victoria |
| Enlistment date | 13 September 1917 |
| Place of enlistment | Melbourne, Victoria |
| 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 | 2nd Casualty Clearing Station |
| Fate | Returned to Australia 25 September 1919 |
