| Regimental number | 3/648 |
| Address | Temuka |
| Marital status | Married |
| Next of kin | Wife, Mrs Eva M L Pridham, c/o P Palmer, Edward Street, St Clair, Dunedin |
| Rank on embarkation | Lieutenant |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 2nd Reinforcements, New Zealand Medical Corps |
| Embarkation details | Unit embarked from Wellington on |
| Miscellaneous details | Nominal Roll Vol. 1: Medical Corps/Second |