| Regimental number | 12104 |
| Occupation | Ploughman |
| Next of kin | Wife, Mrs E A Gray, GPO, Wellington |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 12th Reinforcements (1st Draft), Canterbury Infantry Battalion, C Company |
| Embarkation details | Unit embarked from Wellington on board Ulimaroa on |
| Sources | Nominal Roll Vol. 2: Roll 30, p. 9 |