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In the language of the medical file, “complaint” refers to the symptoms and ailments reported by the patient. In this article, I draw on ethnographic fieldwork conducted between 2004 and 2007 in the mental healthcare setting in South India to argue that the typology of “complaint” and the dialogic exchanges involved in its production mark a far wider catchment area for the allegations and grievances that circulate between patient, kin, clinician, and observing anthropologist. I propose the notion of the register of complaint as a hermeneutic for grappling with the emotionally charged, interactional processes of accusation, arbitration, and reportage that drive clinical modes of inquiry and evaluation in the South Indian mental health encounter. Ethnographic case studies suggest that grievance and accusation command both a vital directive force and evidentiary role in the social, moral, and emotional work of psychiatric diagnosis.[complaint, diagnosis, kinship and family, emotion, psychiatry, South India]