| Regimental number | 3900 |
| Religion | Church of England |
| Occupation | Dentist |
| Address | 27 The Avenue, Moreland, Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Caroline M Pheelan, 27 The Avenue, Moreland, Melbourne, Victoria |
| Enlistment date | 5 August 1915 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/39/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A69 Warilda on 8 February 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
