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Objective/Hypothesis:Objective of this study was to find out the diagnostic accuracy made by emergency physician , this will ensure improvement in patients care and Will help to implement better accuracy in determining diagnostic accuracy . Background:Department of emergency medicine is a specialized care facility in tertiary health care centre whose main function is to take care of patients with immediate and emergent health issues.In view limited literature in EM in India a study between PD vs FD was performed for future reference in continuous quality improvement . Methods:A prospective,observational study was done among 200 patients between provisonal diagnosis made in emergency department vs final discharge diagnosis. Results:Majority of the patients ( n=153 , 76.5%) were from the age group of patients between 15-64 followed by (n=40 , 20% ) in the age group with patients of >65 years age , followed by (n= 7 , 3.5%) in the age group of 1-14 years .Most patients were from department of internal medicine (18.5%) followed by department of cardiology (16%) , followed by department of neuromedicine (13%).it was found that 81% (n=162) cases were accurately ( matched ) diagnosed during Emergency department admission , while there was unmatched diagnosis of 19% cases (n=38). Conclusion:Result obtained suggests that the provisional diagnosis was made by the emergency physicians were mostly matched with final discharge diagnosis that was made by the concerned specialist doctors. This shows that the choice of treatment done in the ER were a prompt and accurate treatment . This has a positive effect on the prognosis , mortality and outcome in patients.Department of internal medicine had more diagnostic errors. Improving history taking of patients with proper clinical evaluation will improve diagnosing patients in the ER. Early availability in blood reports during emergency stay will help as a better diagnostic interpretation of disease. it is required to upgrade clinical skills of emergency physicians in diagnosing pediatric age group.