| Regimental number | 3/250 |
| Address | 100 Wellesley Street, Auckland |
| Marital status | Single |
| Next of kin | Miss Cautley, Pulmont, Gibraltar Crescent, Parnell, Auckland |
| Rank on embarkation | Corporal |
| 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 |