| Regimental number | 3/113 |
| Address | c/o Mrs Davis, 8 Union Street, Hawera |
| Marital status | Single |
| Next of kin | George H Hardley, 24 Franklin Road, Ponsonby, Auckland |
| Rank on embarkation | Private |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, Main Body, New Zealand Medical Corps |
| Embarkation details | Unit embarked from Wellington on |
| Miscellaneous details | Nominal Roll Vol. 1 |