| Religion | Roman Catholic |
| Occupation | Medical practitioner |
| Address | c/o Mrs A Fitzpatrick, 68 Liddiard Street, Glenferrie |
| Marital status | Single |
| Next of kin | - Fitzpatrick, Heyfield, Victoria |
| Enlistment date | |
| Rank on enlistment | Captain |
| Unit name | No 3 Australian General Hospital |
| AWM Embarkation Roll number | 26/67/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |