diff --git a/apps/web-antd/src/views/business/order/product-order/components/cells/OrderUserInfoCell.vue b/apps/web-antd/src/views/business/order/product-order/components/cells/OrderUserInfoCell.vue
index 43fa971e..db4c6ae0 100644
--- a/apps/web-antd/src/views/business/order/product-order/components/cells/OrderUserInfoCell.vue
+++ b/apps/web-antd/src/views/business/order/product-order/components/cells/OrderUserInfoCell.vue
@@ -95,6 +95,64 @@ function handleOpenPatient() {
     patientName: String(patientName(props.row)),
   });
 }
+
+/** 付款人类型文案：1用户 2医生 3就诊人 */
+function payUserTypeLabel(row: Record<string, any>) {
+  const t = Number(row.pay_user_type || 0);
+  if (t === 2) return '医生';
+  if (t === 3) return '就诊人';
+  if (t === 1) return '用户';
+  return '—';
+}
+
+/** 实际付款人用户 ID */
+function resolvePayUserId(row: Record<string, any>) {
+  return Number(row.pay_user_id || row.pay_user?.id || 0);
+}
+
+/** 是否展示代付行：有付款人 ID，或至少有类型（医生代付可回落医生名） */
+function hasPayUserInfo(row: Record<string, any>) {
+  return resolvePayUserId(row) > 0 || Number(row.pay_user_type || 0) > 0;
+}
+
+/** 代付展示名：优先 pay_user 昵称；医生代付可回落医生名 */
+function payUserDisplayName(row: Record<string, any>) {
+  const nick = String(row.pay_user?.nickname || '').trim();
+  if (nick) return nick;
+  if (Number(row.pay_user_type) === 2 && row.doctor?.name) {
+    return String(row.doctor.name);
+  }
+  if (Number(row.pay_user_type) === 3) {
+    return patientName(row);
+  }
+  return '—';
+}
+
+function getPayUserAvatarSrc(row: Record<string, any>) {
+  const raw = String(row.pay_user?.avatarurl ?? '').trim();
+  if (!raw) return defaultAvatar;
+  return resolveAvatarUrl(raw) || defaultAvatar;
+}
+
+/** 点代付用户：按类型打开对应用户/医生/就诊人 */
+function handleOpenPayUser() {
+  const type = Number(props.row.pay_user_type || 0);
+  if (type === 2) {
+    emit('openDoctor', props.row);
+    return;
+  }
+  if (type === 3) {
+    handleOpenPatient();
+    return;
+  }
+  const userId = resolvePayUserId(props.row);
+  if (!userId) return;
+  emit('openUserPatients', {
+    userId,
+    nickname: String(props.row.pay_user?.nickname || ''),
+    avatarurl: String(props.row.pay_user?.avatarurl || ''),
+  });
+}
 </script>
 
 <template>
@@ -163,6 +221,47 @@ function handleOpenPatient() {
         </div>
       </div>
     </div>
+    <div class="order-user-info__row">
+      <Avatar :size="24" :src="getPayUserAvatarSrc(row)" class="shrink-0" />
+      <div class="order-user-info__text min-w-0">
+        <span class="text-[11px] leading-tight text-gray-400 dark:text-slate-500">
+          代付：
+        </span>
+        <template v-if="hasPayUserInfo(row)">
+          <span class="mr-1 text-[11px] text-gray-500 dark:text-slate-400">
+            [{{ payUserTypeLabel(row) }}]
+          </span>
+          <Button
+            v-if="Number(row.pay_user_type) === 2 && row.doctor?.name"
+            class="order-user-info__link-btn !h-auto !px-0 !py-0"
+            type="link"
+            @click.stop="emit('openDoctor', row)"
+          >
+            {{ payUserDisplayName(row) }}
+          </Button>
+          <Button
+            v-else-if="Number(row.pay_user_type) === 3 && resolveUpId(row)"
+            class="order-user-info__link-btn !h-auto !px-0 !py-0"
+            type="link"
+            @click.stop="handleOpenPatient"
+          >
+            {{ payUserDisplayName(row) }}
+          </Button>
+          <Button
+            v-else-if="resolvePayUserId(row)"
+            class="order-user-info__link-btn !h-auto !px-0 !py-0"
+            type="link"
+            @click.stop="handleOpenPayUser"
+          >
+            {{ payUserDisplayName(row) }}
+          </Button>
+          <span v-else class="truncate text-xs text-gray-700 dark:text-slate-200">
+            {{ payUserDisplayName(row) }}
+          </span>
+        </template>
+        <span v-else class="truncate text-xs text-gray-700 dark:text-slate-200">—</span>
+      </div>
+    </div>
   </div>
 </template>
 
diff --git a/apps/web-antd/src/views/doctor/doctor-reception/api/index.ts b/apps/web-antd/src/views/doctor/doctor-reception/api/index.ts
index 234c3cd5..6a5f1375 100644
--- a/apps/web-antd/src/views/doctor/doctor-reception/api/index.ts
+++ b/apps/web-antd/src/views/doctor/doctor-reception/api/index.ts
@@ -547,3 +547,30 @@ export async function goldenFormulaSaveMatchApi(data: {
 }) {
   return requestClient.post<any>(`${prefix}golden-formula-save-match`, data);
 }
+
+/**
+ * 医生新建就诊人并自动挂号
+ * waive_register_fee=1 时免除挂号费
+ */
+export async function createUserPatientApi(data: Record<string, any>) {
+  return requestClient.post<any>(`${prefix}create-user-patient`, data);
+}
+
+/** 当前医生未认领就诊人列表 */
+export async function getUnclaimedUserPatientListApi() {
+  return requestClient.get<any>(`${prefix}unclaimed-user-patient-list`);
+}
+
+/** 就诊人认领小程序码（base64，不上传） */
+export async function getUserPatientClaimQrcodeApi(userPatientId: number) {
+  return requestClient.get<any>(`${prefix}user-patient-claim-qrcode`, {
+    params: { user_patient_id: userPatientId },
+  });
+}
+
+/** 医生代支付小程序码（患者端扫码付） */
+export async function getProxyPayQrcodeApi(orderId: number) {
+  return requestClient.post<any>(`${prefix}proxy-pay-qrcode`, {
+    order_id: orderId,
+  });
+}
diff --git a/apps/web-antd/src/views/doctor/doctor-reception/components/ClaimQrcodeModal.vue b/apps/web-antd/src/views/doctor/doctor-reception/components/ClaimQrcodeModal.vue
new file mode 100644
index 00000000..fb915566
--- /dev/null
+++ b/apps/web-antd/src/views/doctor/doctor-reception/components/ClaimQrcodeModal.vue
@@ -0,0 +1,110 @@
+<script lang="ts" setup>
+/**
+ * 就诊人认领小程序码：选择未认领就诊人后展示 base64 码（不上传）
+ */
+import { ref } from 'vue';
+
+import { useVbenModal } from '@vben/common-ui';
+
+import { Empty, message, Select, Spin } from 'ant-design-vue';
+
+import {
+  getUnclaimedUserPatientListApi,
+  getUserPatientClaimQrcodeApi,
+} from '#/views/doctor/doctor-reception/api';
+
+const loading = ref(false);
+const list = ref<Array<{ id: number; name: string; mobile?: string; age?: number }>>([]);
+const selectedId = ref<number | undefined>();
+const qrcode = ref('');
+const patientName = ref('');
+
+const [Modal, modalApi] = useVbenModal({
+  fullscreenButton: false,
+  draggable: true,
+  showConfirmButton: false,
+  cancelText: '关闭',
+  onCancel() {
+    modalApi.close();
+  },
+  async onOpenChange(isOpen: boolean) {
+    if (!isOpen) return;
+    selectedId.value = undefined;
+    qrcode.value = '';
+    patientName.value = '';
+    loading.value = true;
+    try {
+      const res = await getUnclaimedUserPatientListApi();
+      list.value = Array.isArray(res) ? res : [];
+      const preferId = Number(modalApi.getData()?.user_patient_id || 0);
+      if (preferId > 0 && list.value.some((i) => i.id === preferId)) {
+        selectedId.value = preferId;
+        await loadQrcode(preferId);
+      }
+    } catch (e: any) {
+      message.error(e?.message || '加载未认领就诊人失败');
+    } finally {
+      loading.value = false;
+    }
+  },
+});
+
+/**
+ * 拉取认领码并展示
+ */
+async function loadQrcode(id: number) {
+  if (!id) return;
+  loading.value = true;
+  qrcode.value = '';
+  try {
+    const res = await getUserPatientClaimQrcodeApi(id);
+    qrcode.value = res?.qrcode || '';
+    patientName.value = res?.name || '';
+    if (!qrcode.value) {
+      message.error('二维码生成失败');
+    }
+  } catch (e: any) {
+    message.error(e?.message || '生成认领码失败');
+  } finally {
+    loading.value = false;
+  }
+}
+
+function onSelectChange(id: number) {
+  selectedId.value = id;
+  loadQrcode(id);
+}
+</script>
+
+<template>
+  <Modal class="w-[420px]" title="就诊人二维码认领">
+    <Spin :spinning="loading">
+      <div class="mb-3">
+        <div class="mb-1 text-xs text-[hsl(var(--muted-foreground))]">选择未认领就诊人</div>
+        <Select
+          class="w-full"
+          :value="selectedId"
+          placeholder="请选择"
+          :options="
+            list.map((i) => ({
+              label: `${i.name}（ID:${i.id}${i.mobile ? ' ' + i.mobile : ''}）`,
+              value: i.id,
+            }))
+          "
+          @change="onSelectChange"
+        />
+      </div>
+      <div
+        v-if="qrcode"
+        class="flex flex-col items-center rounded border border-[hsl(var(--border))] bg-[hsl(var(--card,var(--background)))] p-4"
+      >
+        <div class="mb-2 text-sm text-[hsl(var(--foreground))]">
+          {{ patientName || '就诊人' }} · 请用患者端小程序扫码认领
+        </div>
+        <img :src="qrcode" alt="认领二维码" class="h-[220px] w-[220px]" />
+      </div>
+      <Empty v-else-if="!loading && list.length === 0" description="暂无未认领就诊人" />
+      <Empty v-else-if="!loading && !qrcode" description="请选择就诊人以展示认领码" />
+    </Spin>
+  </Modal>
+</template>
diff --git a/apps/web-antd/src/views/doctor/doctor-reception/components/CreateUserPatientModal.vue b/apps/web-antd/src/views/doctor/doctor-reception/components/CreateUserPatientModal.vue
new file mode 100644
index 00000000..7470e59f
--- /dev/null
+++ b/apps/web-antd/src/views/doctor/doctor-reception/components/CreateUserPatientModal.vue
@@ -0,0 +1,276 @@
+<script lang="ts" setup>
+/**
+ * 医生新建就诊人：基础信息 + 健康信息 + 可选免除挂号费，创建后自动挂号
+ */
+import { computed, ref } from 'vue';
+
+import { useVbenModal } from '@vben/common-ui';
+
+import {
+  Col,
+  DatePicker,
+  Form,
+  FormItem,
+  Input,
+  InputNumber,
+  message,
+  Radio,
+  RadioGroup,
+  Row,
+  Select,
+  Switch,
+} from 'ant-design-vue';
+import dayjs, { type Dayjs } from 'dayjs';
+
+import { createUserPatientApi } from '#/views/doctor/doctor-reception/api';
+
+const submitting = ref(false);
+const form = ref(buildEmptyForm());
+const onSuccessCb = ref<null | (() => void)>(null);
+
+const showGuardian = computed(() => Number(form.value.age) > 0 && Number(form.value.age) <= 6);
+
+function buildEmptyForm() {
+  return {
+    name: '',
+    id_card: '',
+    birthday: '' as string,
+    sex: 1,
+    age: undefined as number | undefined,
+    mobile: '',
+    relation: 7,
+    waive_register_fee: true,
+    liver_function: 0,
+    renal_function: 0,
+    liver_index: '',
+    renal_index: '',
+    person_status: 0,
+    allergic_status: 0,
+    family_status: 0,
+    epidemic_status: 0,
+    personal_status: 0,
+    menstrual_status: 0,
+    marital_status: 0,
+    present_status: 0,
+    person_history: '',
+    allergic_history: '',
+    family_history: '',
+    epidemic_history: '',
+    personal_history: '',
+    menstrual_history: '',
+    marital_history: '',
+    present_history: '',
+    guardian_name: '',
+    guardian_id_card: '',
+    guardian_mobile: '',
+    guardian_relation: 0,
+  };
+}
+
+const relationOptions = [
+  { label: '本人', value: 0 },
+  { label: '丈夫', value: 1 },
+  { label: '妻子', value: 2 },
+  { label: '爸爸', value: 3 },
+  { label: '妈妈', value: 4 },
+  { label: '儿子', value: 5 },
+  { label: '女儿', value: 6 },
+  { label: '其他', value: 7 },
+];
+
+const yesNoOptions = [
+  { label: '无', value: 0 },
+  { label: '有', value: 1 },
+];
+
+const [Modal, modalApi] = useVbenModal({
+  fullscreenButton: false,
+  draggable: true,
+  onCancel() {
+    modalApi.close();
+  },
+  async onConfirm() {
+    if (!form.value.name?.trim()) {
+      message.error('请填写姓名');
+      return;
+    }
+    if (!form.value.mobile || !/^\d{11}$/.test(form.value.mobile)) {
+      message.error('请填写正确手机号');
+      return;
+    }
+    if (!form.value.id_card && !form.value.birthday) {
+      message.error('请填写身份证或生日');
+      return;
+    }
+    if (form.value.age == null || form.value.age < 1) {
+      message.error('请填写年龄');
+      return;
+    }
+    if (showGuardian.value) {
+      if (!form.value.guardian_name || !form.value.guardian_id_card || !form.value.guardian_mobile) {
+        message.error('6岁及以下请填写监护人信息');
+        return;
+      }
+    }
+    submitting.value = true;
+    modalApi.setState({ confirmLoading: true });
+    try {
+      await createUserPatientApi({
+        ...form.value,
+        waive_register_fee: form.value.waive_register_fee ? 1 : 0,
+      });
+      message.success('创建成功，已自动挂号');
+      onSuccessCb.value?.();
+      modalApi.close();
+    } catch (e: any) {
+      message.error(e?.message || '创建失败');
+    } finally {
+      submitting.value = false;
+      modalApi.setState({ confirmLoading: false });
+    }
+  },
+  onOpenChange(isOpen: boolean) {
+    if (isOpen) {
+      form.value = buildEmptyForm();
+      const data = modalApi.getData<{ onSuccess?: () => void }>() || {};
+      onSuccessCb.value = data.onSuccess || null;
+    }
+  },
+});
+
+/** 生日选择回填（value-format 时 change 直接给字符串） */
+function onBirthdayChange(v: Dayjs | string | null) {
+  if (!v) {
+    form.value.birthday = '';
+    return;
+  }
+  const str = typeof v === 'string' ? v : v.format('YYYY-MM-DD');
+  form.value.birthday = str;
+  form.value.age = dayjs().diff(dayjs(str), 'year');
+}
+</script>
+
+<template>
+  <Modal class="w-[720px]" title="新建就诊人">
+    <Form layout="vertical" class="create-user-patient-form">
+      <div class="mb-3 text-sm font-medium text-[hsl(var(--foreground))]">基础信息</div>
+      <Row :gutter="12">
+        <Col :span="12">
+          <FormItem label="姓名" required>
+            <Input v-model:value="form.name" placeholder="真实姓名" />
+          </FormItem>
+        </Col>
+        <Col :span="12">
+          <FormItem label="手机号" required>
+            <Input v-model:value="form.mobile" maxlength="11" placeholder="11位手机号" />
+          </FormItem>
+        </Col>
+        <Col :span="12">
+          <FormItem label="身份证号">
+            <Input v-model:value="form.id_card" maxlength="18" placeholder="选填" />
+          </FormItem>
+        </Col>
+        <Col :span="12">
+          <FormItem label="生日" required>
+            <DatePicker
+              class="w-full"
+              :value="form.birthday ? dayjs(form.birthday) : undefined"
+              value-format="YYYY-MM-DD"
+              placeholder="请选择"
+              @change="onBirthdayChange"
+            />
+          </FormItem>
+        </Col>
+        <Col :span="8">
+          <FormItem label="性别" required>
+            <RadioGroup v-model:value="form.sex">
+              <Radio :value="1">男</Radio>
+              <Radio :value="2">女</Radio>
+            </RadioGroup>
+          </FormItem>
+        </Col>
+        <Col :span="8">
+          <FormItem label="年龄" required>
+            <InputNumber v-model:value="form.age" class="w-full" :min="1" :max="200" />
+          </FormItem>
+        </Col>
+        <Col :span="8">
+          <FormItem label="关系">
+            <Select v-model:value="form.relation" :options="relationOptions" />
+          </FormItem>
+        </Col>
+        <Col :span="24">
+          <FormItem label="免除挂号费">
+            <Switch v-model:checked="form.waive_register_fee" checked-children="免除" un-checked-children="收取" />
+            <span class="ml-2 text-xs text-[hsl(var(--muted-foreground))]">
+              开启后挂号费为 0 且标记已支付，可直接接诊
+            </span>
+          </FormItem>
+        </Col>
+      </Row>
+      <template v-if="showGuardian">
+        <div class="mb-3 mt-2 text-sm font-medium text-[hsl(var(--foreground))]">监护人信息</div>
+        <Row :gutter="12">
+          <Col :span="8">
+            <FormItem label="监护人姓名" required>
+              <Input v-model:value="form.guardian_name" />
+            </FormItem>
+          </Col>
+          <Col :span="8">
+            <FormItem label="监护人身份证" required>
+              <Input v-model:value="form.guardian_id_card" maxlength="18" />
+            </FormItem>
+          </Col>
+          <Col :span="8">
+            <FormItem label="监护人手机" required>
+              <Input v-model:value="form.guardian_mobile" maxlength="11" />
+            </FormItem>
+          </Col>
+        </Row>
+      </template>
+      <div class="mb-3 mt-2 text-sm font-medium text-[hsl(var(--foreground))]">健康信息</div>
+      <Row :gutter="12">
+        <Col :span="8">
+          <FormItem label="肝功能异常">
+            <Select v-model:value="form.liver_function" :options="yesNoOptions" />
+          </FormItem>
+        </Col>
+        <Col :span="8">
+          <FormItem label="肾功能异常">
+            <Select v-model:value="form.renal_function" :options="yesNoOptions" />
+          </FormItem>
+        </Col>
+        <Col :span="8">
+          <FormItem label="既往史">
+            <Select v-model:value="form.person_status" :options="yesNoOptions" />
+          </FormItem>
+        </Col>
+        <Col :span="8">
+          <FormItem label="过敏史">
+            <Select v-model:value="form.allergic_status" :options="yesNoOptions" />
+          </FormItem>
+        </Col>
+        <Col :span="8">
+          <FormItem label="家族史">
+            <Select v-model:value="form.family_status" :options="yesNoOptions" />
+          </FormItem>
+        </Col>
+        <Col :span="8">
+          <FormItem label="现病史">
+            <Select v-model:value="form.present_status" :options="yesNoOptions" />
+          </FormItem>
+        </Col>
+        <Col :span="12">
+          <FormItem label="过敏史说明">
+            <Input v-model:value="form.allergic_history" placeholder="有则填写" />
+          </FormItem>
+        </Col>
+        <Col :span="12">
+          <FormItem label="既往史说明">
+            <Input v-model:value="form.person_history" placeholder="有则填写" />
+          </FormItem>
+        </Col>
+      </Row>
+    </Form>
+  </Modal>
+</template>
diff --git a/apps/web-antd/src/views/doctor/doctor-reception/components/PatientPrescriptionHistoryDrawer.vue b/apps/web-antd/src/views/doctor/doctor-reception/components/PatientPrescriptionHistoryDrawer.vue
index c70e2b7d..89a56e1a 100644
--- a/apps/web-antd/src/views/doctor/doctor-reception/components/PatientPrescriptionHistoryDrawer.vue
+++ b/apps/web-antd/src/views/doctor/doctor-reception/components/PatientPrescriptionHistoryDrawer.vue
@@ -37,6 +37,8 @@ type DrawerData = {
   allowWithdraw?: boolean;
   /** 撤回成功后刷新 */
   onWithdrawn?: () => void;
+  /** 医生代支付：打开小程序码 */
+  onProxyPay?: (orderId: number) => void;
 };
 
 const meta = ref<DrawerData>({});
@@ -262,6 +264,20 @@ defineExpose({ drawerApi });
             >
               复用
             </Button>
+            <Button
+              v-if="
+                listTab === 'current' &&
+                row.order_id &&
+                (row.can_withdraw ||
+                  String(row.order_pay_text || '').includes('待支付') ||
+                  Number(row.order_is_pay) === 0)
+              "
+              type="link"
+              size="small"
+              @click="meta.onProxyPay?.(Number(row.order_id))"
+            >
+              代支付
+            </Button>
             <Button
               v-if="meta.allowWithdraw && row.can_withdraw && listTab === 'current'"
               type="link"
diff --git a/apps/web-antd/src/views/doctor/doctor-reception/components/ProxyPayQrcodeModal.vue b/apps/web-antd/src/views/doctor/doctor-reception/components/ProxyPayQrcodeModal.vue
new file mode 100644
index 00000000..74471056
--- /dev/null
+++ b/apps/web-antd/src/views/doctor/doctor-reception/components/ProxyPayQrcodeModal.vue
@@ -0,0 +1,74 @@
+<script lang="ts" setup>
+/**
+ * 医生代支付：展示患者端小程序码，医生用患者端扫码后 JSAPI 付款
+ */
+import { ref } from 'vue';
+
+import { useVbenModal } from '@vben/common-ui';
+
+import { Empty, message, Spin } from 'ant-design-vue';
+
+import { getProxyPayQrcodeApi } from '#/views/doctor/doctor-reception/api';
+
+const loading = ref(false);
+const qrcode = ref('');
+const orderNo = ref('');
+const totalPayPrice = ref('');
+
+const [Modal, modalApi] = useVbenModal({
+  fullscreenButton: false,
+  draggable: true,
+  showConfirmButton: false,
+  cancelText: '关闭',
+  // 从处方记录抽屉内打开：抽屉默认 zIndex=1000，弹窗需更高否则被盖住
+  zIndex: 2000,
+  onCancel() {
+    modalApi.close();
+  },
+  async onOpenChange(isOpen: boolean) {
+    if (!isOpen) return;
+    qrcode.value = '';
+    orderNo.value = '';
+    totalPayPrice.value = '';
+    const orderId = Number(modalApi.getData()?.order_id || 0);
+    if (orderId < 1) {
+      message.error('订单ID无效');
+      return;
+    }
+    loading.value = true;
+    try {
+      const res = await getProxyPayQrcodeApi(orderId);
+      qrcode.value = res?.qrcode || '';
+      orderNo.value = res?.order_no || '';
+      totalPayPrice.value = res?.total_pay_price || '';
+      if (!qrcode.value) {
+        message.error('代支付码生成失败');
+      }
+    } catch (e: any) {
+      message.error(e?.message || '生成代支付码失败');
+    } finally {
+      loading.value = false;
+    }
+  },
+});
+</script>
+
+<template>
+  <Modal class="w-[420px]" title="医生代支付">
+    <Spin :spinning="loading">
+      <div
+        v-if="qrcode"
+        class="flex flex-col items-center rounded border border-[hsl(var(--border))] bg-[hsl(var(--card,var(--background)))] p-4"
+      >
+        <div class="mb-1 text-sm text-[hsl(var(--foreground))]">
+          订单：{{ orderNo || '—' }}
+        </div>
+        <div class="mb-3 text-sm text-[hsl(var(--muted-foreground))]">
+          应付：¥{{ totalPayPrice || '0.00' }} · 请用患者端小程序扫码支付
+        </div>
+        <img :src="qrcode" alt="代支付二维码" class="h-[220px] w-[220px]" />
+      </div>
+      <Empty v-else-if="!loading" description="暂无二维码" />
+    </Spin>
+  </Modal>
+</template>
diff --git a/apps/web-antd/src/views/doctor/doctor-reception/index.vue b/apps/web-antd/src/views/doctor/doctor-reception/index.vue
index 6e4aea27..939fdbe8 100644
--- a/apps/web-antd/src/views/doctor/doctor-reception/index.vue
+++ b/apps/web-antd/src/views/doctor/doctor-reception/index.vue
@@ -14,7 +14,10 @@ import {
   MenuFoldOutlined,
   MenuUnfoldOutlined,
   PlusOutlined,
+  QrcodeOutlined,
+  ReloadOutlined,
   RobotOutlined,
+  UserAddOutlined,
   SaveOutlined,
   StopOutlined,
   SwapOutlined,
@@ -88,6 +91,9 @@ import WesternModal from './components/WesternModal.vue';
 import SimpleProductModal from './components/SimpleProductModal.vue';
 import RefusalOfTreatmentModal
   from "#/views/doctor/doctor-reception/components/RefusalOfTreatmentModal.vue";
+import CreateUserPatientModal from './components/CreateUserPatientModal.vue';
+import ClaimQrcodeModal from './components/ClaimQrcodeModal.vue';
+import ProxyPayQrcodeModal from './components/ProxyPayQrcodeModal.vue';
 // 常用方选择弹窗组件
 import CommonPrescriptionModal from './components/CommonPrescriptionModal.vue';
 import GoldenFormulaModal from './components/GoldenFormulaModal.vue';
@@ -338,15 +344,27 @@ const salespersonTransferPrescriptionId = ref(0);
 const salespersonTransferDrawerOpen = ref(false);
 const hasSalespersonTransfer = ref(false);
 
-/** 当前接诊挂号 ID（模板中不可直接使用 localStorage） */
+/**
+ * 当前接诊挂号 ID
+ * 优先用响应式的 selectPatientId；勿只读 localStorage（computed 不追踪 storage，会卡死旧挂号 id）
+ */
 const doctorReceptionRegisterId = computed(() => {
+  if (selectPatientId.value > 0) {
+    return selectPatientId.value;
+  }
   if (typeof window === 'undefined' || !window.localStorage) {
     return 0;
   }
-  return Number.parseInt(
-    window.localStorage.getItem('doctorReception-id') || '0',
-    10,
-  );
+  const raw = window.localStorage.getItem('doctorReception-id') || '0';
+  // 兼容历史 JSON.stringify(number) 写入
+  try {
+    const parsed = JSON.parse(raw);
+    const n = Number(parsed);
+    if (Number.isFinite(n) && n > 0) return n;
+  } catch {
+    /* ignore */
+  }
+  return Number.parseInt(raw, 10) || 0;
 });
 
 /** 门店类型接口短时缓存，供毛利率 / 转诊提示共用，避免进页双打 */
@@ -542,8 +560,29 @@ function updatePatientList() {
   getPatientListByReception();
 }
 
+/** 患者列表手动刷新中（与轮询区分，避免连点） */
+const patientListRefreshing = ref(false);
+
+/**
+ * 手动刷新左侧患者列表
+ * 为什么单独抽：工具栏刷新需 loading，且不改动当前/历史 tab 的 updateTabType 语义
+ */
+function refreshPatientList() {
+  if (patientListRefreshing.value) return;
+  patientListRefreshing.value = true;
+  getPatientList({
+    type: listType.value,
+  })
+    .then((res) => {
+      patients.value = res;
+    })
+    .finally(() => {
+      patientListRefreshing.value = false;
+    });
+}
+
 getPatientListByReception();
-// 每5秒更新数据
+// 每 30 秒轮询刷新患者列表
 setInterval(getPatientListByReception, 30_000);
 
 // 药品分类（后端下发；失败时用本地兜底）
@@ -830,11 +869,8 @@ const selectPatient = async (patient: Patient, isUpdateTabType = true) => {
     }
   });
 
-  localStorage.setItem(
-    `doctorReception-id`,
-    // JSON.stringify(selectData),
-    JSON.stringify(patient.id),
-  );
+  // 存纯数字字符串，避免 JSON.stringify 造成读取歧义
+  localStorage.setItem(`doctorReception-id`, String(patient.id));
   getCurrentDrugs();
 };
 
@@ -1305,6 +1341,21 @@ const [RefusalOfTreatmentModals, RefusalOfTreatmentModalApi] = useVbenModal({
   connectedComponent: RefusalOfTreatmentModal,
 });
 
+/** 新建就诊人弹窗 */
+const [CreateUserPatientModals, CreateUserPatientModalApi] = useVbenModal({
+  connectedComponent: CreateUserPatientModal,
+});
+
+/** 就诊人认领码弹窗 */
+const [ClaimQrcodeModals, ClaimQrcodeModalApi] = useVbenModal({
+  connectedComponent: ClaimQrcodeModal,
+});
+
+/** 医生代支付码弹窗 */
+const [ProxyPayQrcodeModals, ProxyPayQrcodeModalApi] = useVbenModal({
+  connectedComponent: ProxyPayQrcodeModal,
+});
+
 // ==================== 常用方弹窗 ====================
 const [CommonPrescriptionModals, CommonPrescriptionModalApi] = useVbenModal({
   connectedComponent: CommonPrescriptionModal,
@@ -1336,6 +1387,41 @@ function openCommonPrescriptionModal() {
   CommonPrescriptionModalApi.open();
 }
 
+/** 打开新建就诊人弹窗 */
+function openCreateUserPatientModal() {
+  CreateUserPatientModalApi.setData({
+    onSuccess: () => refreshPatientList(),
+  });
+  CreateUserPatientModalApi.open();
+}
+
+/**
+ * 当前就诊人是否未认领（user_id=0）
+ * 认领码入口仅在未认领时出现在右侧工具栏
+ */
+const isActivePatientUnclaimed = computed(() => {
+  const up = activePatient.value as any;
+  if (!up?.id) return false;
+  return Number(up.user_id || 0) === 0;
+});
+
+/** 打开就诊人认领二维码（优先当前选中患者） */
+function openClaimQrcodeModal() {
+  const upId = Number(activePatient.value?.id || patientInfo.value?.user_patient_id || 0);
+  ClaimQrcodeModalApi.setData({ user_patient_id: upId || undefined });
+  ClaimQrcodeModalApi.open();
+}
+
+/** 打开医生代支付小程序码 */
+function openProxyPayQrcode(orderId: number) {
+  if (!orderId) {
+    message.error('订单ID无效');
+    return;
+  }
+  ProxyPayQrcodeModalApi.setData({ order_id: orderId });
+  ProxyPayQrcodeModalApi.open();
+}
+
 /**
  * 打开金方导入弹窗（VIP：golden_formula）；仅中药处方可用
  */
@@ -2374,11 +2460,18 @@ function openPatientMrCiteDrawer() {
 
 /** 打开处方记录抽屉 */
 function openPatientRxHistoryDrawer() {
+  // 挂号 id 必须用 getRegisterId（当前选中挂号），禁止用就诊人 id 冒充
+  const registerId = getRegisterId();
+  if (!registerId) {
+    message.warning('请先选择接诊患者');
+    return;
+  }
   patientRxHistoryDrawerApi.setData({
-    registerId: Number(doctorReceptionRegisterId.value || selectPatientId.value || 0),
+    registerId,
     userPatientId: Number(activePatient.value?.id || 0),
     patientName: activePatient.value?.name,
     allowWithdraw: true,
+    onProxyPay: openProxyPayQrcode,
     onReuse: reusePrescriptionFromList,
     // 点击处方号打开详情（与医生名片/患者管理一致）
     onDetail: (prescriptionId: number) => openPrescriptionDetail(prescriptionId),
@@ -3121,6 +3214,9 @@ function onStoreSelectOpenChange(open: boolean) {
 <template>
   <div class="reception-layout" :class="{ 'is-left-collapsed': !leftShow }">
     <RefusalOfTreatmentModals />
+    <CreateUserPatientModals />
+    <ClaimQrcodeModals />
+    <ProxyPayQrcodeModals />
     <InfoModalComponent />
     <!-- 左侧患者列表：悬停展开、移出收起；收起态仅箭头+背景提示 -->
     <aside
@@ -3162,15 +3258,33 @@ function onStoreSelectOpenChange(open: boolean) {
             {{ item.name }}
           </SelectOption>
         </Select>
-        <RadioGroup
-          v-model:value="listType"
-          class="w-full"
-          style="text-align: center"
-          @change="updatePatientList"
-        >
-          <RadioButton :value="1" class="w-1/2">当前</RadioButton>
-          <RadioButton :value="2" class="w-1/2">历史</RadioButton>
-        </RadioGroup>
+        <div class="patient-list-toolbar flex items-center gap-1">
+          <RadioGroup
+            v-model:value="listType"
+            class="min-w-0 flex-1"
+            style="text-align: center"
+            @change="updatePatientList"
+          >
+            <RadioButton :value="1" class="w-1/2">当前</RadioButton>
+            <RadioButton :value="2" class="w-1/2">历史</RadioButton>
+          </RadioGroup>
+          <Button
+            type="text"
+            size="small"
+            class="patient-list-refresh-btn shrink-0"
+            title="刷新患者列表"
+            :loading="patientListRefreshing"
+            @click="refreshPatientList"
+          >
+            <ReloadOutlined />
+          </Button>
+        </div>
+        <div class="patient-list-actions mb-2 mt-1 flex flex-wrap gap-1">
+          <Button size="small" type="primary" ghost @click="openCreateUserPatientModal">
+            <UserAddOutlined />
+            就诊人
+          </Button>
+        </div>
         <div
           v-for="(patient, index) in patients"
           :key="index"
@@ -3244,6 +3358,15 @@ function onStoreSelectOpenChange(open: boolean) {
         <Button type="link" size="small" @click="openPatientInfoDrawer">患者信息</Button>
         <Button type="link" size="small" @click="openPatientMrCiteDrawer">患者病历</Button>
         <Button type="link" size="small" @click="openPatientRxHistoryDrawer">处方记录</Button>
+        <Button
+          v-if="isActivePatientUnclaimed"
+          type="link"
+          size="small"
+          @click="openClaimQrcodeModal"
+        >
+          <QrcodeOutlined />
+          认领码
+        </Button>
       </div>
       <SpecialPrescriptionImportCard
         v-if="specialPrescriptionRecord && hasSpecialPrescriptionRecord"
@@ -3296,6 +3419,15 @@ function onStoreSelectOpenChange(open: boolean) {
               <MedicineBoxOutlined />
               处方记录
             </Button>
+            <Button
+              v-if="isActivePatientUnclaimed"
+              type="link"
+              size="small"
+              @click="openClaimQrcodeModal"
+            >
+              <QrcodeOutlined />
+              认领码
+            </Button>
             <Button
               v-if="receptionStatus === 2"
               type="link"