In this research, for the first time we present design and implementation of a reference-spur-free, low phase noise, sub-mW dual modulation mode (frequency shift keying (FSK) and on-off keying (OOK)) 400 MHz transmitter (TX) for wearable health monitoring, where RF synthesis depends solely on an extremely low phase noise oscillator, which uses a 400 MHz surface acoustic wave resonator and does not include any power hungry, spur- generating frequency multiplier or phase/frequency lock loop. The proposed TX has been designed and fabricated in 180 nm CMOS technology. Measurement results show that the energy efficiencies of the proposed TX in FSK and OOK mode are 1.8 nJ/bit at 250 kb/s and 0.23 nJ/bit at 2 Mb/s, respectively. To prove the utility of the proposed TX, bio-signal communication is also demonstrated with the help of a commercial receiver in actual operating scenarios, where the measured bit error rate in FSK mode was < 10e-5 for range of 2 m.