In a complex system like the Indian public health system, it may be difficult to introduce Electronic Health Records (EHR) without a good understanding of how patients interact with their health records. This qualitative/interpretive research study looks at how patients in the public health system construct meaning of the paper based health records which includes doctor’s prescription/notes, lab test and other diagnostic reports. While organizations in the public and private sectors try to tap into the ICT in healthcare space, most of their ongoing work seems to take into account a doctor’s perspective of health records. This study aims at expanding this to also include the patients’ perspectives; Field-work in the Kolar district of Karnataka involving interviews of patients under the National Mental Health Programme of Government of India and observations of their interactions with the medical staff and facilities.