Christian Medical College and Hospital (CMCH), Vellore, Tamil Nadu, was founded in 1900 as a one-bed clinic by Dr. Ida Sophia Scudder. Since then, CMCH has grown into an institution of international repute with over 1800 beds and 4000 employees. CMCH attends to more than 1800 inpatients and 2500 outpatients daily. Outpatient services at CMCH are offered over 40 different clinics covering a number of specialties, supported by a comprehensive range of investigation facilities. The objective of this case is to bring out the complexity of the Med-OPD process at CMCH focusing on the interaction between various medical units, and argue for a computer simulation of the OPD process as the test way to evaluate alternatives for improvement in outpatient services.