Background: Clients are a major stakeholder in public health system. Client satisfaction studies help in informing policy makers about felt needs to improve quality of care. Hence, client satisfaction was measured in public health facilities of Punjab state in India. Methodology: A random sample of 4928 patients from the Out-Patient Department (OPD) and 224 from the In-Patient Department (IPD) were interviewed using two separate Likert Scales in OPD and IPD respectively from all 22 districts of the state. The items in these scales were incorporated by literature search and new items were identified by focused group discussions (FGDs) with the community and expert consultation. Scoring and ranking methods were used to compare various types of health facilities and districts. Results: More than half (59% IPD and 58% OPD) of the clients were from rural area, 57% were women in OPD and 50% IPD. One third rated OPD registration system as poor due to delay in registration and lack of sufficient space in seating areas and wanted doctors to give more time during consultation to explain their condition. In IPD 15% rated food quality to be poor, and 18% rated cleanliness especially that of the toilets to be poor, and 7% rated availability of medicines to be poor. Most of the clients in IPD & OPD were satisfied with the behavior of the staff. Conclusions: Overall, majority (73%) of the clients were very satisfied with the IPD & OPD services. Satisfaction level varied by districts and by type of health facility. Key words: Communities and environments, Community engagement, Health systems. Key messages: 1. Only 73% clients were very satisfied with the public health services. 2. Satisfaction level was lowest for registration system. 3. Client satisfaction varies by the type of health facility and by districts.