diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/appointmentmanage/appservice/impl/TicketAppServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/appointmentmanage/appservice/impl/TicketAppServiceImpl.java
index 7c00ceec..8fc6bd76 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/appointmentmanage/appservice/impl/TicketAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/appointmentmanage/appservice/impl/TicketAppServiceImpl.java
@@ -71,10 +71,39 @@ public class TicketAppServiceImpl implements ITicketAppService {
         }
 
         try {
-            // 3. 执行原有的预约逻辑
+            // 3. 号源列表来自排班表(adm_doctor_schedule)，需确保clinical_ticket中存在对应记录
+            Ticket existingTicket = ticketService.selectTicketById(ticketId);
+            if (existingTicket == null) {
+                DoctorSchedule schedule = doctorScheduleMapper.selectById(slotId);
+                if (schedule == null) {
+                    return R.fail("排班记录不存在");
+                }
+                Ticket newTicket = new Ticket();
+                newTicket.setId(slotId);
+                newTicket.setDoctor(schedule.getDoctor());
+                newTicket.setDepartment(String.valueOf(schedule.getDeptId()));
+                newTicket.setDoctorId(schedule.getDoctorId());
+                newTicket.setDepartmentId(schedule.getDeptId());
+                String registerItem = schedule.getRegisterItem();
+                if (registerItem != null && registerItem.contains("专家")) {
+                    newTicket.setTicketType("expert");
+                } else {
+                    newTicket.setTicketType("general");
+                }
+                newTicket.setStatus("unbooked");
+                int totalFee = (schedule.getRegisterFee() != null ? schedule.getRegisterFee() : 0)
+                             + (schedule.getDiagnosisFee() != null ? schedule.getDiagnosisFee() : 0);
+                newTicket.setFee(String.valueOf(totalFee));
+                String timeRange = schedule.getStartTime() + "-" + schedule.getEndTime();
+                newTicket.setTime(LocalDate.now() + " " + timeRange);
+                // 使用MyBatis-Plus的save方法，支持手动设置ID
+                ticketService.save(newTicket);
+            }
+
+            // 4. 执行预约逻辑
             int result = ticketService.bookTicket(params);
             if (result > 0) {
-                // 4. 预约成功后，更新排班表状态
+                // 5. 预约成功后，更新排班表状态
                 DoctorSchedule schedule = new DoctorSchedule();
                 schedule.setId(slotId);             // 对应 XML 中的 WHERE id = #{id}
                 schedule.setIsStopped(true);         // 设置为已预约
@@ -86,14 +115,12 @@ public class TicketAppServiceImpl implements ITicketAppService {
                 if (updateCount > 0) {
                     return R.ok("预约成功并已更新排班状态");
                 } else {
-                    // 如果更新失败，可能需要根据业务逻辑决定是否回滚预约
                     return R.ok("预约成功，但排班状态更新失败");
                 }
             } else {
                 return R.fail("预约失败");
             }
         } catch (Exception e) {
-           // e.printStackTrace();
             log.error(e.getMessage());
             return R.fail("系统异常：" + e.getMessage());
         }
diff --git a/openhis-ui-vue3/src/views/appoinmentmanage/outpatientAppointment/index.vue b/openhis-ui-vue3/src/views/appoinmentmanage/outpatientAppointment/index.vue
index e8d12851..81b85466 100644
--- a/openhis-ui-vue3/src/views/appoinmentmanage/outpatientAppointment/index.vue
+++ b/openhis-ui-vue3/src/views/appoinmentmanage/outpatientAppointment/index.vue
@@ -177,8 +177,8 @@
                 <tr v-for="(patient, index) in patients" :key="patient.idCard" :class="{ selected: selectedPatientId === patient.idCard }" @click="selectPatient(patient.idCard)">
                   <td>{{ index + 1 }}</td>
                   <td>{{ patient.name }}</td>
-                  <td>{{ patient.medicalCard }}</td>
-                  <td>{{ patient.gender || '-' }}</td>
+                  <td>{{ patient.id || patient.medicalCard }}</td>
+                  <td>{{ getGenderText(patient.genderEnum_enumText || patient.genderEnum || patient.gender || patient.sex) }}</td>
                   <td>{{ patient.idCard }}</td>
                   <td>{{ patient.phone }}</td>
                   <td>
@@ -436,7 +436,7 @@ export default {
           records = response;
         }
         
-        this.patients = records;        
+        this.patients = records;
         // 在前端进行额外的模糊匹配过滤（以防后端API不支持完整的模糊匹配）
         if (hasSearchCriteria) {
           this.patients = this.patients.filter(patient => {
@@ -599,40 +599,17 @@ export default {
         ElMessage.error('患者数据未加载，请先搜索患者');
         return;
       }
-      
+
       this.selectedPatientId = patientId;
       // 保存选择的患者对象 - 使用idCard作为唯一标识，但增加容错性
       this.selectedPatient = this.patients.find(patient => {
-        // 尝试多种匹配方式
         const matchByIdCard = patient.idCard === patientId;
         const matchById = patient.id === patientId;
         const matchByMedicalCard = patient.medicalCard === patientId;
-        const match = matchByIdCard || matchById || matchByMedicalCard;        
-        return match;
+        return matchByIdCard || matchById || matchByMedicalCard;
       });
       if (this.selectedPatient) {
-        // 使用 ElMessageBox.confirm 进行二次确认
-        ElMessageBox.confirm(
-          `确认选择患者 ${this.selectedPatient.name} 进行预约？`,
-          '患者确认',
-          {
-            confirmButtonText: '确定',
-            cancelButtonText: '取消',
-            type: 'info'
-          }
-        ).then(() => {
-          // 用户点击确定，自动滚动到确认按钮
-          ElMessage.success('已选择患者: ' + this.selectedPatient.name);
-          const confirmBtn = document.querySelector('.confirm-btn');
-          if (confirmBtn) {
-            confirmBtn.scrollIntoView({ behavior: 'smooth', block: 'nearest' });
-          }
-        }).catch(() => {
-          // 用户取消选择，清空已选患者
-          this.selectedPatientId = null;
-          this.selectedPatient = null;
-          ElMessage.info('已取消患者选择');
-        });
+        ElMessage.success('已选中患者: ' + this.selectedPatient.name);
       } else {
         ElMessage.error('未找到该患者，请重新选择');
         this.selectedPatientId = null;
@@ -643,59 +620,68 @@ export default {
         ElMessage.error('请选择患者');
         return;
       }
-      
+
       if (!this.currentTicket) {
         ElMessage.error('预约信息错误，请重新选择号源');
         this.closePatientSelectModal();
         return;
       }
-      
+
+      // 再次验证号源是否仍处于可预约状态
+      if (this.currentTicket.status !== '未预约') {
+        ElMessage.error('该号源已被预约，请选择其他号源');
+        this.closePatientSelectModal();
+        return;
+      }
+
       try {
         const userStore = useUserStore();
         const appointmentData = {
-          slotId: this.currentTicket.slot_id, // 添加号源ID
-          ticketId: Number(this.currentTicket.slot_id),
+          ticketId: this.currentTicket.slot_id, // 号源ID，保持原始类型避免大数字精度丢失
+          slotId: this.currentTicket.slot_id, // 号源ID
           patientId: this.selectedPatientId, // 使用身份证号作为患者ID，不需要转换为数字
           patientName: this.selectedPatient.name,
-          medicalCard: this.selectedPatient.medicalCard,
+          medicalCard: this.selectedPatient.medicalCard || this.selectedPatient.id,
           phone: this.selectedPatient.phone,
-          gender: this.selectedPatient.gender,
+          gender: this.getGenderValueForBackend(this.selectedPatient),
           fee: Number(this.currentTicket.fee) || 0,
           regType: this.currentTicket.ticketType === 'general' ? '普通' : '专家',
           tenant_id: userStore.tenantId || '1' // 修改为tenant_id以匹配后端数据库字段名
         };
-        
+
         // 验证必填字段
-        if (!appointmentData.ticketId || isNaN(appointmentData.ticketId)) {
+        if (!appointmentData.ticketId) {
           ElMessage.error('号源ID无效');
           return;
         }
-        
+
         if (!appointmentData.patientId) {
           ElMessage.error('患者ID无效');
           return;
         }
         // 调用真实API进行预约
-        bookTicket(appointmentData).then(response => {        
+        bookTicket(appointmentData).then(response => {
           const ticketIndex = this.tickets.findIndex(t => t.slot_id === this.currentTicket.slot_id);
           if (ticketIndex !== -1) {
             this.tickets[ticketIndex].status = '已预约';
             this.tickets[ticketIndex].patientName = this.selectedPatient.name;
-            this.tickets[ticketIndex].patientId = this.selectedPatient.medicalCard;
-            this.tickets[ticketIndex].patientGender = this.selectedPatient.gender;
-            
+            this.tickets[ticketIndex].patientId = this.selectedPatient.medicalCard || this.selectedPatient.id;
+            this.tickets[ticketIndex].patientGender = this.selectedPatient.genderEnum_enumText || this.selectedPatient.genderEnum || this.selectedPatient.gender || this.selectedPatient.sex;
+
             // 更新医生号源列表中的余号数量
             this.updateDoctorsList();
           }
-          
+
           this.closePatientSelectModal();
-          
+
           // 重新加载号源数据，确保显示最新状态
           this.onSearch();
-          
+
           ElMessage.success('预约成功，号源已锁定。患者到院签到时需缴费取号。');
         }).catch(error => {
-          ElMessage.error('预约失败，请稍后重试。');
+          // 显示具体的错误信息
+          const errorMessage = error.response?.data?.msg || error.response?.data?.message || '预约失败，请稍后重试。';
+          ElMessage.error(errorMessage);
         });
       } catch (error) {
         ElMessage.error('预约信息格式错误，请重新操作。');
@@ -710,6 +696,56 @@ export default {
     toggleSidebar() {
       this.showSidebar = !this.showSidebar;
     },
+    // 获取性别文本
+    getGenderText(genderValue) {
+      // 如果值为null或undefined，返回'-'
+      if (genderValue === null || genderValue === undefined) {
+        return '-';
+      }
+      
+      // 将值转换为字符串进行比较
+      const strValue = String(genderValue).toLowerCase();
+      
+      // 处理男性值
+      if (strValue === '0' || strValue === '男' || strValue === 'male' || strValue === 'm' || 
+          strValue === 'malegender' || strValue === 'man' || strValue === 'boy' || 
+          strValue === '男性' || strValue === '男士') {
+        return '男';
+      }
+      
+      // 处理女性值
+      if (strValue === '1' || strValue === '女' || strValue === 'female' || strValue === 'f' || 
+          strValue === 'femalegender' || strValue === 'woman' || strValue === 'girl' || 
+          strValue === '女性' || strValue === '女士') {
+        return '女';
+      }
+      
+      // 如果都不是，返回原值或'-'
+      return '-';
+    },
+    // 获取用于后端的性别值
+    getGenderValueForBackend(patient) {
+      // 优先使用数字类型的genderEnum或gender字段
+      if (patient.genderEnum !== undefined && patient.genderEnum !== null) {
+        return patient.genderEnum;
+      }
+      if (patient.gender !== undefined && patient.gender !== null) {
+        return patient.gender;
+      }
+      
+      // 如果genderEnum_enumText是"男性"或"女性"，转换为对应的数字
+      if (patient.genderEnum_enumText) {
+        const text = patient.genderEnum_enumText.toLowerCase();
+        if (text === '男性' || text === '男') {
+          return 0;
+        } else if (text === '女性' || text === '女') {
+          return 1;
+        }
+      }
+      // 默认返回0（男性）
+      return 0;
+    },
+    
     // 检测是否为移动设备
     checkMobileDevice() {
       this.isMobile = window.innerWidth <= 768;