| Regimental number | 102 |
| Place of birth | Tewkesbury, England |
| Religion | Church of England |
| Occupation | Farmer |
| Marital status | Single |
| Age at embarkation | 24 |
| Height | 5' 7.5" |
| Weight | 165 lbs |
| Next of kin | Mrs. Elizabeth Bloxham, Church Street, Tewkesbury, Gloucestershire, England |
| Previous military service | Nil |
| Enlistment date | |
| Place of enlistment | Dalby, Queensland |
| Rank on enlistment | Private |
| Unit name | 11th Light Horse Regiment, A Squadron |
| AWM Embarkation Roll number | 10/16/1 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A7 Medic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Light Horse Regiment |
| Recommendations (Medals and Awards) |
Military Medal |
| Fate | Discharged in London |
| Medals |
Military Medal 'For bravery in the field.'
Source: 'Commonwealth Gazette' No 1 Date: |
| Discharge date | |
| Other details |
War service: Egypt, Gallipoli, Palestine Discharged in London, 14 November 1919. Medals: Military Medal, 1914-15 Star, British War Medal, Victory Medal |