The undersigned, _____________, accuses _____________ of the crime of LESS SERIOUS PHYSICAL INJURIES, committed as follows, to wit:
That on or about _____________, at about _________ (a.m./p.m.), in the City/Municipality of _____________, Province of _____________ and within the jurisdiction of this Honorable Court, the said accused did there and then willfully, unlawfully and feloniously, and without justifiable cause therefor, attack, assault, and beat one _____________, punching and kicking him in different parts of his body, thereby inflicting on the latter wounds in different parts of his body, which have required and will require medical attention for a period of not less than ten (10) days but not more than (30) days, and have incapacitated and will incapacitate him from labor for the same period of time.
Contrary to law.
_____________, Philippines, __Date__.
(Certification of Preliminary Investigation)