| Regimental number | 8/1969 |
| Address | Athol, Southland |
| Marital status | Single |
| Next of kin | Father, Thomas Douglas, Neptune Street, St Kilda, Melbourne, Victoria, Australia |
| Rank on embarkation | Private |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 4th Reinforcements, Otago Infantry Battalion |
| Embarkation details | Unit embarked from Wellington on board Willochra on |
| Miscellaneous details | Nominal Roll Vol. 1: Otago Infantry Batln/Fourth |