| Trade: | Greengrocer |
| Age: | 34 years 120 days |
| Regiment: | Royal Fusiliers |
| Regimental No: | 3849 |
| Attested: | 03.09.1914 |
| Discharged: | 15.10.1914 |
| Reason for Discharge: | Chronic Bronchitis and Emphysema |
| Next of Kin: | Caroline Banyard |
| Address: | 27 Walham Avenue, Walham Green |