| Regimental number | 170 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of Christ |
| Occupation | Motor driver |
| Address | Middle Park, Victoria |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs B Clark, 4 Fraser Street, Middle Park, Victoria |
| Enlistment date | 24 April 1915 |
| Rank on enlistment | Private |
| Unit name | No 1 Australian General Hospital |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board A62 Wandilla on 25 June 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Field Ambulance |
| Fate | Returned to Australia 2 March 1919 |
