The undersigned, _____________, accuses _____________ of the crime of SLIGHT 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 him on the face, thereby inflicting on the latter physical injuries, which have required and will require medical attention for a period of one to nine 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)