| cemetery | Warszawa (Okopowa) |
| sector | 17a |
| row | 1 |
| number | 20 |
| sex | M |
| surname | Hertz |
| first name | Chaim Salomon |
| hebrew name | Chaim Shlomo |
| fathers name | Michael |
| husbands name | |
| maiden name | |
| date of birth (m/d/y) (m/d/r) | |
| date of death (m/d/y) (m/d/r) | 3/28/1921 |
| additional info | żył lat 72 |
