| Regimental number | 4363 |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Woolwich, New South Wales |
| Marital status | Single |
| Age at embarkation | 34 |
| Next of kin | Mother, Mrs S A Culverwell, 'Ivydean', Hatfield Road, Weston-super-Mere, Somerset, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 3rd Australian General Hospital |
| AWM Embarkation Roll number | 26/67/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on |
| Miscellaneous details (Nominal Roll) | see other |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
