| Regimental number | 17/290 |
| Address | Royal Hotel, Hawera, Taranaki |
| Marital status | Single |
| Next of kin | Friend, George Gibson, Royal Hotel, Hawera, Taranaki |
| Rank on embarkation | Trooper |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 3rd Reinforcements, New Zealand Veterinary Corps |
| Embarkation details | Unit embarked from Wellington on board Aparima on |
| Miscellaneous details | Nominal Roll Vol. 1: Veterinary Corps/Third |