| Regimental number | 3/391 |
| Address | 28 High Street, Musselburgh, Dunedin |
| Marital status | Single |
| Next of kin | Father, Peter Couch, 28 High Street, Musselburgh, Dunedin |
| Rank on embarkation | Private |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 2nd Reinforcements, Ambulance |
| Embarkation details | Unit embarked from Wellington on |
| Miscellaneous details | Nominal Roll Vol. 1: Ambulance/Second |