Objective: The study explores community’s knowledge about tuberculosis and causes of exclusion from sputum examinations at designated government facilities under the Revised National Tuberculosis Control Programme in West Bengal, India. Methods: The prevalence of suspected tuberculosis is 10% among persons attending in a medical Out Patient Department (OPD). Here, survey based work has been carried out on 90 persons with cough for two weeks or more from representative sample of 36 Designated Microscopy Centre (DMC) catchment areas. Demographic and socio-economic characteristics, vulnerabilities of participants in respect to tuberculosis infection, participants’ knowledge regarding tuberculosis infection and symptoms, level stigma and facilities available at govt sector meant for tuberculosis have been studied by survey questionnaire. Results: Results indicated that overall knowledge about tuberculosis is significantly poor among the participants. Among 90 participants, 26.7% knew without being probed by the surveyor that people with cough more than or equal to two weeks are susceptible to have tuberculosis; and whereas, 50.0% participants could mention this with probe. Knowledge score of participants about six key symptoms of tuberculosis (0-6 scale: Yes-1, No-0) were assessed to see that 75.6% participants lying in lower knowledge score level (0-2) compared to 24.4% in the higher knowledge score level. Among several factors knowledge about tuberculosis and stigma are significantly associated with exclusion from access to sputum examination services within duration of two weeks’ cough. Conclusion: The survey based study identified respondent’s poor knowledge level and stigma attached to tuberculosis as important factors for exclusion from early sputum examination from DMC or TU. Finally, study results provide opportunity to review the matter in details through qualitative research among certain excluded groups in connection to different approaches for intervention.