| Regimental number | 20719 |
| Place of birth | Little Bras D'or Canada |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Gormanston, Tasmania |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs M Phelan, South Side, Little Bras d'Orr, Cape Britten, Nova Scotia, Canada |
| Enlistment date | 23 April 1917 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, General Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A36 Boonah on 22 October 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Field Ambulance |
| Fate | Effective abroad (still overseas) |
