diff --git a/openhis-ui-vue3/src/views/doctorstation/components/hospitalizationDialog.vue b/openhis-ui-vue3/src/views/doctorstation/components/hospitalizationDialog.vue
index e3f5e100..f6f401f3 100644
--- a/openhis-ui-vue3/src/views/doctorstation/components/hospitalizationDialog.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/hospitalizationDialog.vue
@@ -184,10 +184,11 @@
 </template>
 
 <script setup>
+import {watch} from 'vue';
 import {getDiagnosisDefinitionList, getInit, getOrgList, handleHospitalization, wardList,} from './api.js';
 
 const submitForm = reactive({
-  medTypeCode: '21',
+  medTypeCode: '', // 从字典动态获取默认值
 });
 
 const props = defineProps({
@@ -217,6 +218,17 @@ let diagnosisYbNo = '';
 const { proxy } = getCurrentInstance();
 
 const { med_type } = proxy.useDict('med_type');
+
+// 监听诊断类别字典加载，默认选择第一项（仅当没有主诊断时）
+watch(
+  med_type,
+  (newVal) => {
+    if (newVal && newVal.length > 0 && !submitForm.medTypeCode && !props.mainDiagnosis) {
+      submitForm.medTypeCode = newVal[0].value;
+    }
+  },
+  { immediate: true }
+);
 const rules = reactive({
   diagnosisDefinitionId: [
     {
@@ -277,10 +289,38 @@ function openDialog() {
 
       console.log('筛选后的组织机构数据:', organization.value);
 
-      // 如果当前患者所属科室在筛选结果中，则默认选中
+      // 默认选中当前医生所在科室（即使不在住院科室列表中）
       if (props.patientInfo?.orgId) {
-        submitForm.inHospitalOrgId =
-          organization.value.find((item) => item?.id === props.patientInfo.orgId)?.id || '';
+        const doctorOrgId = props.patientInfo.orgId;
+        const exists = organization.value.some((item) => item?.id === doctorOrgId);
+        
+        if (exists) {
+          // 如果医生科室在列表中，直接选中
+          submitForm.inHospitalOrgId = doctorOrgId;
+        } else {
+          // 如果医生科室不在列表中（如门诊科室），临时添加到列表并选中
+          // 从原始数据中找到医生科室信息
+          const findOrgInTree = (nodes, orgId) => {
+            for (const node of nodes) {
+              if (node.id === orgId) return node;
+              if (node.children) {
+                const found = findOrgInTree(node.children, orgId);
+                if (found) return found;
+              }
+            }
+            return null;
+          };
+          const doctorOrg = findOrgInTree(res.data.records, doctorOrgId);
+          if (doctorOrg) {
+            organization.value.unshift(doctorOrg);
+            submitForm.inHospitalOrgId = doctorOrgId;
+          }
+        }
+        
+        // 触发科室选择事件，加载对应病区
+        if (submitForm.inHospitalOrgId) {
+          handleNodeClick({ id: submitForm.inHospitalOrgId });
+        }
       }
     } else {
       organization.value = [];
@@ -310,9 +350,21 @@ function openDialog() {
     submitForm.diagnosisDefinitionId = props.mainDiagnosis.definitionId;
     diagnosisDefinitionId = props.mainDiagnosis.definitionId;
     diagnosisYbNo = props.mainDiagnosis.ybNo || '';
-    submitForm.medTypeCode = props.mainDiagnosis.medTypeCode;
     submitForm.diagnosisDesc = props.mainDiagnosis.name || ''; // 设置诊断描述
     diagnosisDefinitionList.value = [props.mainDiagnosis];
+    
+    // 诊断类别：优先使用主诊断的medTypeCode，但要验证是否在字典选项中
+    const diagnosisMedTypeCode = props.mainDiagnosis.medTypeCode;
+    const medTypeExists = med_type.value && med_type.value.some(item => item.value === diagnosisMedTypeCode);
+    if (medTypeExists) {
+      submitForm.medTypeCode = diagnosisMedTypeCode;
+    } else if (med_type.value && med_type.value.length > 0) {
+      // 如果主诊断的medTypeCode不在字典中，默认选择字典第一项
+      submitForm.medTypeCode = med_type.value[0].value;
+    }
+  } else if (med_type.value && med_type.value.length > 0) {
+    // 无主诊断时，默认选择字典第一项
+    submitForm.medTypeCode = med_type.value[0].value;
   }
 }
 
diff --git a/openhis-ui-vue3/src/views/inHospitalManagement/charge/register/components/registerForm.vue b/openhis-ui-vue3/src/views/inHospitalManagement/charge/register/components/registerForm.vue
index 425dbe82..329d8abc 100644
--- a/openhis-ui-vue3/src/views/inHospitalManagement/charge/register/components/registerForm.vue
+++ b/openhis-ui-vue3/src/views/inHospitalManagement/charge/register/components/registerForm.vue
@@ -200,6 +200,7 @@
   </div>
 </template>
 <script setup>
+import {watch} from 'vue';
 import {
   diagnosisInit,
   getPractitionerWard,
@@ -219,6 +220,17 @@ const { in_way_code, admit_source_code, med_type } = proxy.useDict(
   'med_type'
 );
 
+// 监听诊断类别字典加载，默认选择第一项
+watch(
+  med_type,
+  (newVal) => {
+    if (newVal && newVal.length > 0 && !submitForm.medTypeCode) {
+      submitForm.medTypeCode = newVal[0].value;
+    }
+  },
+  { immediate: true }
+);
+
 const emits = defineEmits([]);
 const props = defineProps({
   patientInfo: {
@@ -337,7 +349,7 @@ const submitForm = reactive({
   startTime: formatDateStr(new Date(), 'YYYY-MM-DD HH:mm:ss'), // 	入院日期
   priorityEnum: props.inHospitalInfo.priorityEnum, // 患者病情（字典：PatAdmCondition）
   ambDiagnosisName: props.inHospitalInfo.ambDiagnosisName,
-  medTypeCode: '21',
+  medTypeCode: '', // 从字典动态获取默认值
 });
 // /* 科室 病区 */
 // watch(
@@ -445,6 +457,23 @@ function getInitOptions() {
 
     // 过滤出与病区关联过的科室
     organization.value = allOrgs.filter((org) => linkedOrgIds.has(org.id));
+
+    // Bug #178 Fix: 如果已选科室不在列表中，手动添加以确保正确显示
+    const selectedOrgId = props.inHospitalInfo?.inHospitalOrgId;
+    const selectedOrgName = props.inHospitalInfo?.inHospitalOrgName;
+    if (selectedOrgId && selectedOrgName) {
+      const exists = organization.value.some((org) => org.id === selectedOrgId);
+      if (!exists) {
+        // 将已选科室添加到列表中，确保el-tree-select能正确显示名称
+        organization.value.unshift({
+          id: selectedOrgId,
+          name: selectedOrgName,
+          typeEnum: 2,
+          classEnum: '2',
+          children: []
+        });
+      }
+    }
   });
 
   // if (!props.noFile) {