This paper tries to show the trend of registration of patients (indoor & outdoor) in various medical institutes of Ahmedabad which are run by the Ahmedabad Municipal Corporation (AMC) in last 24 years (1971-94). The Civil Hospital which is run by State Government was also studies for the same time period for comparison. The trend analysis of the registered patients is based on the secondary data available from AMC. The study shows that in last 24 years there is substantial decline in outdoor patients in most of the hospitals under AMC inspite of 3.6% annual increase in city population. Only Civil hospital shows a rising trend. Overall number of indoor admissions have increased somewhat in AMC hospitals. But it was mostly in tertiary hospitals, while in smaller hospitals & maternity homes number of indoor admissions have declined. On the other hand there is a marked rise in number of private nursing homes over this period. The paper also tried to explore the likely reason for such trend in patient registration. It also discusses the policy implications for providing quality health service to the citizens.