| Regimental number | 1551 |
| Religion | Church of England |
| Occupation | Cook |
| Address | Mary A. McIntosh, 99 Bevan Street, South Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Aunt, Mary A. McIntosh, 99 Bevan Street, Southy Melbourne, Victoria |
| Enlistment date | 7 July 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Light Horse Regiment, 12th Reinforcement |
| AWM Embarkation Roll number | 10/9/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A40 Ceramic on 23 November 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
