Tacna Heroica
| # | Player | MIN | G | A | YC | RC |
|---|---|---|---|---|---|---|
| Kleiber Palomino | 90 | 0 | 0 | 0 | 0 | |
| Gustavo Loayza | 90 | 0 | 0 | 0 | 0 | |
| Angel Perez | 90 | 0 | 0 | 0 | 0 | |
| A. Garrafa Tapia I. | 90 | 0 | 0 | 0 | 0 | |
| Totals | 360 | 0 | 0 | 0 | 0 |
U. San Martin
| # | Player | MIN | G | A | YC | RC |
|---|---|---|---|---|---|---|
| Carlos Lopez | 90 | 1 | 0 | 0 | 0 | |
| Totals | 90 | 1 | 0 | 0 | 0 |
Goal scorers aren't recorded for every goal in this game (1 of 2 attributed).