REPUBLIC OF THE PHILIPPINES

Department of Justice
OFFICE OF THE PROSECUTOR
VIGAN CITY

JORDAN UGALE
Complainant

I.S. NO. 2020-12-001

-versus- For: Serious Physical Injuries

ACCUSED, JAY LAGUIO

Respondent

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COMPLAINT-AFFIDAVIT

I, JORDAN UGALE, of legal age, Filipino Citizen, single, residing

at Tamag, Vigan City, after having duly sworn to in accordance with
law do hereby depose and state:

(1) That I am the complainant in the above-entitled case;

(2) That I am formally charging respondent JAY LAGUIO, with the
postal address at Tamag, Vigan City for the crime of Serious Physical
Injuries penalized under Art. 263 of the Revised Penal Code,
committed as follows, to wit:

a. That I was at the basketball court in the morning of the 2 nd of

August, 2020 playing basketball with respondent;
b. That he got irritated when I asked him about his girlfriend
and a heated argument ensued after;
c. That he was accusing me of flirting with his girlfriend;
d. That while I was talking, he grabbed a stone with the size of a
fist and threw it at me hitting my left eye;
e. That he punched my face thrice afterwards, which made me
fall down on the ground;
f. That he then fled the scene;
g. That a certain Vincent Ocampo and Cleo Lim, who were also
in the court delivered me to Gabriela Silang General Hospital
whereby I was examined;
h. That Dr. Stephen Tubon ordered me to be admitted in the
hospital and referred me to an ophthalmologist expert, Dr.
Juan Quinto, for further examination of my left eye. I stayed
in the hospital for 45 days for the treatment of my swollen
left cheek and treatment of eye.
 i. That my left eye was treated for two months and an eye
surgery was conducted but to no avail, I wasn’t able to see
from my left eye. Copy of the medical certificate is attached
as Annex “A” hereof;
j. That on the 12th of October, I filed a complaint before the
Vigan Police Station and as evidenced by the police blotter
attached as Annex “B”.

(3) That I am executing this complaint-affidavit in order to file a case

of Serious Physical Injuries penalized under Art. 263 of the Revised
Penal Code against Jay Laguio and that I am attesting to the
truthfulness of the foregoing statements.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th

of December, 2020, in the City of Vigan

jugale
JORDAN UGALE
Complainant

SUBSCRIBED AND SWORN TO before me this 9 th of December, 2020,

in Vigan City.

jtamag
JOHNLEN TAMAG
ASST. CITY PROSECUTOR

CERTIFICATION

I hereby certify that I have personally examined the affiant and am

satisfied that he voluntarily executed and of his own free will

jtamag
JOHNLEN TAMAG
ASST. CITY PROSECUTOR
MCLE Compliance 123456778
April 21, 2020
 ANNEX “A”

JUAN U. QUINTO, MD
Department of Ophthalmology
Gabriela Silang General Hospital
Quirino Boulevard, Vigan City Ilocos Sur
Clinic Hours 10:00 AM – 3:00 PM TTHS

MEDICAL CERTIFICATE

Date: October 10, 2020

TO WHOM IT MAY CONCERN:

This is to certify that JORDAN UGALE, age 20, male, with the
postal address at Tamag, Vigan City was examined/ hospitalized at
Gabriela Silang General Hospital starting on August 2 nd of 2020; that
the patient is diagnosed to have suffered from swollen left cheek and
cracked eye socket which required confinement and treatment for 45
days; that even after surgery, his left sight cannot be restored and is
considered to have permanently loss his left vision.

Thank you!

jquinto
JUAN QUINTO, M.D.
License no: 101234
 ANNEX “B”

Republic of the Philippines

National Police Commission
Philippine National Police
Vigan Police Station
Vigan City

MEMORANDUM

FOR : PCOL Ronald M. Tagao

Ilocos Sur Police Provincial Office
Bulag, Camp Elpidio Quirino
Bantay, Ilocos Sur

FROM : Officer-in-charge
Vigan Police Station

SUBJECT : Spot Report on Alleged Serious

Physical Injury

Date : October 12, 2020

1. Blotter Entry No. 2020-120;

Page number 30;
Nature of the or incident – Serious Physical Injury
Date/Time of Occurrence – 0930H August 02, 2020
Place of Occurrence – Tamag, Vigan City, Ilocos Sur

2. The victim is 20 years of age, single, a resident of Tamag, Vigan

City while the accused is 22 years of age, single, also residing in
the same place.

3. That on or about 9:30 in the morning of August 2, 2020 in the

basketball court of Tamag, Vigan City, upon initial investigation
conducted by the officers of this station led by SPO1 Raul Torres
revealed that the accused and the victim are playing basketball
together; they had an altercation arising from the accusation of
the accused that the victim and his girlfriend are flirting with
each other; that during the disagreement, the accused got a
stone and threw it on the face of the victim hitting the left eye
portion of the face of the victim; that immediately after throwing
the stone, the accused punched the head of the victim causing
the latter to fall; that this series of events were witnessed by
Cleo Lim and Vincent Ocampo, who were also the one who
brought the victim to Gabriela Silang General Hospital.

4. This office is informed about the incident through a complaint by

the victim.
 5. If there is any further development about the case, progress
report will follow.

tuy
PO2 Helen R. Unzo Ty Uy
Drafter Police Senior Inspector