Fragmentation in heterogenous and widely distributed HISs (Health Information System) is a global problem and is still challenging to make them interoperable. One of the key factors includes the lack of standardization especially for the semantic interoperability layer. Presently, the Indian health ministry is making efforts nationwide to implement a set of standards that are designed for addressing the issue of interoperability in the health system. My research focused on exploring these health standards and analyzing how well they are implemented and adapted in and for the Indian primary health care level. The broader research project within which my thesis is situated focused on implementing HISs at two empirical sites in northern India. My research is a joint effort with the HISP-India team where, qualitative research methods were used for my data collection and data analysis, and the methodology was a combination of case study and action research. The work presented in this thesis mainly focused on identifying implementation challenges of government notified standards and finding possible approaches to address them. This thesis also provides description of the project sites, workshops, the developments that took place over the course of the design, development and implementation of the HIS. I focused on understanding of what all health data standards were followed, and the challenges and limitations experienced. Some of the key findings shows that the standards are not yet fully developed to accomplish the needs of semantic interoperability and are incomplete in serving the needs of primary health care.