| Regimental number | 8/1197 |
| Address | 480 Leith Street, Dunedin |
| Marital status | Single |
| Next of kin | Mother, Mrs W Blacklow, 480 Leith Street, Dunedin |
| Rank on embarkation | Private |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 2nd Reinforcements, Otago Infantry Battalion |
| Embarkation details | Unit embarked from Wellington on board Willochra on |
| Miscellaneous details | Nominal Roll Vol. 1: Otago Infantry Batln/Second |