| Regimental number | 3/94a |
| Address | Hospital Street, Greymouth |
| Marital status | Single |
| Next of kin | Mother, Mrs Sarah Willis, Hospital Street, Greymouth |
| 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 |