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Introduction Every surgical procedure is followed by thorough and descriptive documentation. The Royal College of Surgeons (RCS) introduced official guidelines in 2014 on the proper documentation of operative notes. These guidelines are concise, targeted, and easy to adapt to any surgical specialty. Methods and results An audit was conducted from April to September 2019 at District Headquarter Hospital in Rawalpindi, Pakistan. We analyzed 215 operative notes of elective and emergency cases during the first three m