| cemetery | Warszawa (Okopowa) |
| sector | 9 |
| row | 17 |
| number | 22 |
| sex | |
| surname | grób symboliczny |
| first name | |
| hebrew name | |
| fathers name | |
| husbands name | |
| maiden name | |
| date of birth (m/d/y) (m/d/r) | |
| date of death (m/d/y) (m/d/r) | |
| additional info | grób symboliczny lista imion nieczytelna |
