| Regimental number | 3/174 |
| Address | c/o Mrs Perkins, 9 Lipman Street, Wellington |
| Marital status | Single |
| Next of kin | Mrs Murton, Norman Road, Faversham, Kent, 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 |