Rank:


Service No(s):


Regiment:


Unit:

Returned:

No

Place of birth:

Occupation:

Date of death:

Cause of death:

Grave or panel reference:

Name of father:

Name of siblings:

Name(s) of children:

Died:

Yes

Date of birth:

Place of enlistment:

Event:

Age at death:

Cemetery or memorial:

Other memorial:

St. Mellitus Church

Name of mother:

Name of spouse:

Address: