Aim: To explore the completeness rate of paper-based psychiatric medical records (PMRs) and to investigate the factors effective on documentation status. Material & Methods: The current study was a retrospective, descriptive study. The study was conducted in the Department of Psychiatry, MGM Medical College, Kishanganj, Bihar, India from April 2010 to April 2011. A checklist was developed based on the instructions of the Ministry of Health that were related to evaluate the completeness rate of documentation. The checklist covered all data elements in paper‑based PMRs and comprised 10 sections according to PMR forms, including summary of admission and discharge, summary of psychiatric records, psychiatric history and assessment, progress note, consultation, physician orders, nursing report, vital signs control, laboratory tests, and electroencephalogram (EEG) report. Each section encompasses several data elements. Results: Out of 53 items in PMR forms, the kappa value of 11 items was significant and in 8 items, the agreement was not significant. There was no documentation defect in 15.2% of PMRs. The range of completeness rate in paper‑based PMR sheets was from 7.5% to 51.2%. “Admission and discharge” (49.4%), “nursing report” (47.7%), and “progress note” (32%) had the highest number of defects, respectively. “EEG report” (n = 4.57%), “laboratory tests report” (21.3%), and “vital sign” (9.3%) had the lowest number of documentation defects, respectively. Conclusion: Based on our results, it is suggested to conduct regular evaluation and provide feedback to the health‑care providers, and conduct training courses.