four Rak`ah prayer in each Rak`ah recite the Surah of al-Fatihah once and the Surah of al-Tawheed one hundred times.
After accomplishment, you may say the following dua:

اللّهُمَّ إنِّي إلَيْكَ فَقِيرٌ،

allahumma inni ilayka faqirun

O Allah: I am in need for You,

وَمِنْ عَذَابِكَ خَائِفٌ مُسْتَجِيرٌ.

wa min `adhabika kha’ifun mustajirun

and I am fearful of You and seeking Your shelter against Your chastisement.

اللّهُمَّ لا تُبَدِّلِ اسْمِي،

allahumma la tubaddil ismi

O Allah: (please) do not erase my name,

وَلا تُغَيِّرْ جِسْمِي،

wa la tughayyir jismi

and do not change my body,

وَلا تَجْهَدْ بَلائِي،

wa la tajhad bala’y

and do not increase my ordeals,

وَلا تُشْمِتْ بِي أَعْدَائِي،

wa la tushmit by a`da’y

and do not make my enemies rejoice at my misfortune.

أَعُوذُ بِعَفْوِكَ مِنْ عِقَابِكَ،

a`udhu bi`afwika min `iqabika

I resort to Your pardon against Your punishment,

وَأَعُوذُ بِرَحْمَتِكَ مِنْ عَذَابِكَ،

wa a`udhu birahmatika min `adhabika

and I resort to Your mercy against Your chastisement,

وَأَعُوذُ بِرِضَاكَ مِنْ سَخَطِكَ،

wa a`udhu biridaka min sakhatika

and I resort to Your pleasure against Your wrath,

وَأَعُوذُ بِكَ مِنْكَ،

wa a`udhu bika minka

and I resort to You from You

جَلَّ ثَنَاؤُكَ

jalla thanau´uka

Enormous be the praise of You

أَنْتَ كَمَا أَثْنَيْتَ عَلَى نَفْسِكَ

anta kama athnayta `ala nafsika

You are as exactly as You have praised Yourself,

وَفَوْقَ مَا يَقُولُ الْقَائِلُونَ.

wa fawqa ma yaqulu alqa’iluna

and above all that which is said about You.