Background: Okhaldhunga community hospital lies in rural Nepal, and is a hospital with simple equipment and facilities. The supply of power is little, therefore it does not excist any electronical medical record system. Each patient has its own notebook, which serves as their medical record, and each patient is responsible for this medical record. That means that they bring their medical record back home when they are discharged from the hospital, and the hospital has no archive. Two other norwegian medical students had been to OCH in January 2011 to write an assigmnet about how the medical record system at this hospital worked in general. Now the norwegian doctor, who is the medical coordinator at OCH, gave us the opportunity to write about how the medical record system works in acute situations. Method: As the two students in the former study, we chose to use a quantitative and a qualitative design on our study. For the quantitative design we developed a questionnaire concerning the medical record system. For this we used the questionnaire from the former study as a template, and Dr. Bøhler who works at OCH guided us. For approximately two months (december 2012 and january 2013) we hired a staff at the hospital who filled in the questionnaire based on information from patients admitted to hospital after office hour. Our qualitative study had a different perspective than the former study. Instead of making a study from the patient s view, we wanted to see how the doctors experienced the system. There were 4 doctors working at the hospital at the moment we visited Okhaldhunga - Dr. Bøhler was one of them, and the 3 others were young Nepali doctors working at the hospital as a part of their residency to become a general practitioner. We did a semi-structured interview on all four of them, which we only used as a support to our quantitative part of the study. Main results: In our quantitative part we had 163 questionnaires that were relevant to use in our study. Nevertheless it was large enough to determine that the compliance in bringing the book is different in acute situations compared to during office time. We found that 63% (102/163) brought the medical record, while the former study found a compliance of 1834/2045. We found that pregnant women had a great compliance in bringing the book. Short time since last visit also stands out as a link between patients with compliance. As the motivation for bringing the medical record, we found that the main reason (63/102) was because they knew that the medical record had relevant content. Concerning the other group, the ones that did not bring the medical record, the main reason for that was because of urgency in the acute situation (25/61). 18/61 did not bring the medical record because they had lost it,and 15/61 because they had forgotten it. Conclusion: It seems that the MR system at OCH is a feasible solution with the facilities and resources they have at disposal. Still there is not good enough power-supply or resources for choosing an electronically medical record system. The aim will be to continue to improve the current system and continue to state the importance of bringing the MR to the patients.