| Regimental number | 12610 |
| Occupation | Mental hospital attendant |
| Next of kin | Mother, Mrs A Keats, 61 Regent Street, Woolston, Christchurch |
| Rank on embarkation | Trooper |
| Unit name | New Zealand Expeditionary Force, 12th Reinforcements (2nd Draft), New Zealand Mounted Rifles Brigade |
| Embarkation details | Unit embarked from Wellington on |
| Sources | Nominal Roll Vol. 2: Roll 31, p. 2 |