| Regimental number | 19780 |
| Place of birth | Hull England |
| Religion | Church of England |
| Occupation | Tram conductor |
| Address | Annandale, New South Wales |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs E Amery, 125 View Street, Annandale, New South Wales |
| Enlistment date | 4 September 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A36 Boonah on 29 October 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Field Ambulance |
| Fate | Effective abroad (still overseas) |
