| Regimental number | 3/591 |
| Address | Somes Island, Wellington |
| Marital status | Single |
| Next of kin | Miss Nellie Jackson, 'Kananock', Hoodle Street, Elsternwick, Melbourne, Victoria, Australia |
| Rank on embarkation | Corporal |
| 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: Medical Corps/Main Body |