| cemetery | Otwock |
| sector | |
| row | 5 |
| number | 20 |
| sex | M |
| surname | Goldschlak |
| first name | |
| hebrew name | Menachem Mendel |
| fathers name | Yehuda Leibush |
| husbands name | |
| maiden name | |
| date of birth (m/d/y) (m/d/r) | |
| date of death (m/d/y) (m/d/r) | 3/29/1927 |
| additional info | z Ciechanowa |
