| Plantilla | Partidos jugados | ||
| Orden |
| Nombre |  |
 |
 |
 |
 |
 |
 |
 |
 |
| Hector Chumpitaz | 90' | 1 | 1 | - | - | - | - | - | - |
| Teófilo Cubillas | 90' | 1 | 1 | - | - | - | - | - | - |
| Rubén Díaz | 90' | 1 | 1 | - | - | - | - | - | - |
| Julio Meléndez | 90' | 1 | 1 | - | - | - | - | - | - |
| Juan Muñante | 90' | 1 | 1 | - | - | - | - | - | - |
| José Navarro | 90' | 1 | 1 | - | - | - | - | - | - |
| Juan Oblitas | 90' | 1 | 1 | - | - | - | - | - | - |
| Alfredo Quesada | 90' | 1 | 1 | - | - | - | - | - | - |
| Ramón Quiroga | 90' | 1 | 1 | - | - | - | - | - | - |
| Percy Rojas | 28' | 1 | - | 1 | - | - | - | - | - |
| Hugo Sotil | 62' | 1 | 1 | - | 1 | - | - | - | - |
| José Velásquez | 90' | 1 | 1 | - | - | - | - | - | - |
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