| Regimental number | 3/654 |
| Address | 45 Weston Road, St Albans, Christchurch |
| Marital status | Single |
| Next of kin | Mother, Mrs G H Burrell, 45 Weston Road, St Albans, Christchurch |
| Rank on embarkation | Private |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, New Zealand Medical Corps, Ambulance/No 2 New Zealand Stationary Hospital |
| Embarkation details | Unit embarked from Wellington on board HMNZT24 Mauganui on |
| Miscellaneous details | Nominal Roll Vol. 1: Ambulance/No 2 NZ Stationary Hospital |