| cemetery | Warszawa (Okopowa) |
| sector | 12b |
| row | 13 |
| number | 16 |
| sex | M |
| surname | Goldberg |
| first name | Szymon |
| hebrew name | Shimon |
| fathers name | Yosef |
| husbands name | |
| maiden name | |
| date of birth (m/d/y) (m/d/r) | |
| date of death (m/d/y) (m/d/r) | 8/3/1928 |
| additional info | żył 79 lat |
