REPUBLIC OF THE PHILIPPINES

Barangay TEODORA ALONZO

BAGUIO CITY

Date: September 10, 2018

TO: Hon. Anwar Erorita Aberin

Barangay Chairman

COMPLAINT

Mr. Jamie Ramirez Raña

Complainant

- Against- For: Slight Physical Injuries

Mr. Korina Sanchez Roxas

Respondent
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I, hereby complain against above named respondent for violating my rights

and interests in the following manner:

On September 7, 2018, at around 10:00 in the morning, near the Baguio Health
Department at the park, I was on my way towards Minute Burger to meet up with a
friend, the respondent called out for me, however we had a quarrel before so I ignored
her and continued, because of that she forcefully grabbed my hair from the back which
cause me to twist and slip and hit my cheekbone in a rock, so I developed a cut and
contusion below my eye.

Therefore, I pray that the following reliefs be granted to me in accordance

with law and equity:

1. That I receive a sincere apology from the respondent and;

2. That I be indemnified for my expenses in the treatment of my cut and
contusion.

Attachments:

A. Photocopy of Valid ID of complainant.

B. Names and addresses of witnesses.
C. Medical Certificate

Signed by: Jamie Ramirez Raña

1. Jasmine Olipas of #58 Malvar Street, Teodora Alonzo, Baguio City

2. Ian Umangil, KsLoft, Teodora Alonzo, Baguio City

3. Anzar Erorita, #92, Palma 2nd Road, Baguio City

 MEDICAL CERTIFICATE

I, the undersigned Dr. Vladimir Delavre , Doctor of Medicine, certify that the

examination of Mrs. Jamie Ramirez Raña reveals that she suffered from a laceration

below her right eye because of minor blunt force trauma and a contusion surrounding

the eye.

Date: September 7, 2018 Doctor: