| Regimental number | 9716 |
| Religion | Presbyterian |
| Occupation | Labourer |
| Address | Carlton, Victoria |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, J Fyvie, 414 Margaret Street, Carlton, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Dermatological Hospital, 3rd Reinforcement |
| AWM Embarkation Roll number | 26/103/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on |
| Miscellaneous details (Nominal Roll) | see other |