| Place of birth | Wandsworth England |
| Religion | Church of England |
| Occupation | Surgeon |
| Address | Hobart, Tasmania |
| Marital status | Married |
| Age at embarkation | 58 |
| Next of kin | Wife, Mrs E Z Payne, 320 Elizabeth Street, Hobart, Tasmania |
| Enlistment date | |
| Rank on enlistment | Captain |
| Unit name | Medical Officers |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board RMS Mongolia on |
| Miscellaneous details (Nominal Roll) | No details against name on Nominal Roll |