| Enlisted | 09.12.1915 |
| Age on Enlistment | 40 years 6 months |
| Regiment | 25th Rifle Brigade |
| Regimental no. | 210151 |
| Rank | Rifleman |
| Residence | 8 Mostyn Road, Brixton |
| Trade | French Polisher |
| Wife | Ada Maria Davies |
| Date of Discharge | 19.10.1917 |
| Reason for Discharge | Chronic Rheumatism |