A low power, low phase noise PLL-less oscillator was designed utilizing a 400 MHz surface acoustic wave resonator (SAWR). Using the SAWR oscillator, a reference spur-free OOK MedRadio band transmitter (TX) was proposed. The removal of spurs wth the proposed direct carrier generation method enables multiple user to communicate in the narrow MedRadio band without any significant interference. The proposed oscillator and TX were designed and fabricated in 180 nm UMC processs, which were successfully characterized post fabrication.