| Regimental number | 12643 |
| Place of birth | Marryatville South Australia |
| Religion | Roman Catholic |
| Occupation | Student |
| Address | 14 Broadway, Glenelg, South Australia |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs M Mallan, 14 Broadway, Glenelg, South Australia |
| Previous military service | 78th Infantry |
| Enlistment date | 17 June 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Field Ambulance |
| AWM Embarkation Roll number | 26/54/1 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A29 Suevic on 31 May 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Field Ambulance |
| Fate | Returned to Australia 13 May 1919 |
| Date of death | 30 July 1975 |
| Place of burial | Centennial Park Cemetery |