| cemetery | Warszawa (Okopowa) |
| sector | 18 |
| row | 18 |
| number | 25 |
| sex | M |
| surname | Jakobsohn |
| first name | |
| hebrew name | Chaim Yaakov |
| fathers name | Aharon Menachem |
| 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. Sivan 5687r. |
