| cemetery | Warszawa (Okopowa) |
| sector | 47 |
| row | 19 |
| number | 21 |
| sex | M |
| surname | Tik |
| first name | |
| hebrew name | Shimon |
| fathers name | David Shlomo |
| husbands name | |
| maiden name | |
| date of birth (m/d/y) (m/d/r) | |
| date of death (m/d/y) (m/d/r) | 1/31/1921 |
| additional info | z Nowego Miasta |
