| Regimental number | 6241 |
| Place of birth | Moruya New South Wales |
| Religion | Church of England |
| Occupation | Storekeeper |
| Address | 457 Marrickville Road, Dulwich Hill, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 43 |
| Next of kin | Sister, Laura Donaths, 457 Marrickville Road, Dulwich Hill, Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | MED26.66.2R11 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Field Ambulance |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Toowong Cemetery |