| cemetery | Warszawa (Okopowa) |
| sector | 15 |
| row | 29 |
| number | 6 |
| sex | F |
| surname | Poliker |
| first name | |
| hebrew name | Chaia Dvora |
| fathers name | Shmuel |
| husbands name | Mordechai |
| maiden name | |
| date of birth (m/d/y) (m/d/r) | |
| date of death (m/d/y) (m/d/r) | |
| additional info | zm. 6 elul |
