| Regimental number | 3/3479 |
| Occupation | Printer |
| Next of kin | Mother, Mrs E Willis, 11 Rugby Street, Merivale, Christchurch |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 28th Reinforcements (First Draft), New Zealand Medical Corps |
| Embarkation details | Unit embarked from Wellington on board HMNZT 89 Waitemata on |
| Sources | Nominal Roll Vol. 3: Roll 69, p. 19 |