Introduction: The outpatient department is the shop window of the hospital and first contact point. The objective is to study work flow and service perception.    Methods: pilot study was conducted for one month to identify   points of care.  Cross sectional study for a period of one year with pre–structured questionnaire with four point Likert scale in    domains of front office, billing, consultation, ancillary and facilities. The overall opinion and difference with past experience by review patients.    Results and Conclusions :  overall opinion– very good to good is 86.66%,.94.50% about consultation ,85.21%  front office and billing,84.40% and 78.40% about   facilities ancillary services.12.50% dissatisfied about doctors, 14.79% billing , 21.60% sample collection , 14.80% felt fair to poor about  toilets , lifts and wheel chair   .Recommendations: Regular monitoring and supervision by the administration to reduce delays at all points of care.