| Date of birth | |
| Place of birth | Boort Victoria |
| Religion | Roman Catholic |
| Occupation | Soldier |
| Address | 'Kathalorn', Bambra Road, Caulfield, Victoria |
| Marital status | Married |
| Age at embarkation | 40 |
| Next of kin | Wife, Mrs C V Ryan, 'Kathalorn', Bambra Road, Caulfield, Victoria |
| Previous military service | A&I Staff |
| Enlistment date | |
| Rank on enlistment | Lieutenant |
| Unit name | 17th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on |
| Promotions |
Lieutenant Unit: Unallotted (abroard) Promotion date: |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |