| Regimental number | 3/117a |
| Address | c/o DIC, Christchurch |
| Marital status | Single |
| Next of kin | Aunt, Miss Twiney, 592 Cashel Street, Linwood, Christchurch |
| Rank on embarkation | Sergeant |
| 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 |