| Regimental number | 3/121 |
| Address | c/o W G Malone, Stratford, Taranaki |
| Marital status | Single |
| Next of kin | Mrs Mary Keen, Dulwich, London, England |
| 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: Medical Corps/Main Body |