| Regimental number | 10036 |
| Place of birth | Stawell Victoria |
| Religion | Presbyterian |
| Occupation | Storekeeper |
| Address | Main Street, Stawell |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, John McIntosh, Main Street, Stawell |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | Infantry Brigade 6, Field Ambulance 6, Reinforcement 11 |
| AWM Embarkation Roll number | 26/49/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A23 Suffolk on |
| Rank from Nominal Roll | Private |
| Fate | Returned to Australia |
| Miscellaneous details (Nominal Roll) | 15th Field Ambulance |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
