(๔)

คําฟอง
คดีหมายเลขดําที.่ ....................... /๒๕..........

ศาล .........................................................
วันที่ ........... เดือน ................................... พุทธศักราช ๒๕ ...........
ความ ...............................

................................................................................................................................................... โจทก
ระหวาง
................................................................................................................................................... จําเลย
ขอหาหรือฐานความผิด .............................................................................................................................................
จํานวนทุนทรัพย .....................................................................................................บาท ...............................สตางค
ขาพเจา .............................................................................................................................................
เลขประจําตัวประชาชน ---- โจทก เชื้อชาติ……………………………………..
สัญชาติ .........................อาชีพ .........................................อายุ ..........ป อยูบา นเลขที่ ...........................หมูที่...........
ถนน ................................ ตรอก/ซอย ..........................ตําบล/แขวง ............................อําเภอ/เขต………..…………..
จังหวัด ..........................................................รหัสไปรษณีย.........................โทรศัพท ...............................................
โทรสาร ............................................... ไปรษณียอเิ ล็กทรอนิกส ...............................................................................
ขอยื่นฟอง ..................................................................................................................................................................
เลขประจําตัวประชาชน ---- จําเลย เชื้อชาติ .........................................
สัญชาติ ..........................อาชีพ ......................................อายุ .............ป อยูบา นเลขที่ ........................หมูท ี่ ...........
ถนน ................................ตรอก/ซอย ..........................ตําบล/แขวง ...........................อําเภอ/เขต……….……………...
จังหวัด ......................................................รหัสไปรษณีย.........................โทรศัพท ...................................................
โทรสาร .................................................. ไปรษณียอิเล็กทรอนิกส ............................................................................
มีขอความตามที่จะกลาวตอไปนี้
ขอ ๑ .............................................................................................................................................
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