ABSTRACT
Primary Healthcare Centers [PHCs] play a vital role in public health system in rural areas in India. Some, of the patients visiting these PHCs are then referred to tertiary care facilities. Reasons for referral include unsure diagnosis or inadequate facilities for treatment. In this study almost 86% of patients showed improvement after treatment at referral centers while twelve referred patients did not seek treatment after getting symptomatic relief. Two referred patients, one with uncontrolled diabetes and the other with AMI died. IHD in rural areas need special attention. We feel that establishing a link between Primary Health Care Centers and tertiary care centers besides building capacity of PHC centers to manage chronic diseases needs special attention