| Regimental number | 67630 |
| Place of birth | Gippsland Victoria |
| Religion | Roman Catholic |
| Occupation | Machineman |
| Address | Coff's Harbor, Jetty, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs B Fern, Coff's Harbor, Jetty, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 26 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
