| cemetery | Warszawa (Okopowa) |
| sector | 58 |
| row | 17 |
| number | 20 |
| sex | M |
| surname | Wa... |
| first name | |
| hebrew name | Shimon David |
| fathers name | Menachem Baruch |
| husbands name | |
| maiden name | |
| date of birth (m/d/y) (m/d/r) | |
| date of death (m/d/y) (m/d/r) | |
| additional info | zm. 8 adar I |
