diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/controller/AppointmentController.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/controller/AppointmentController.java
new file mode 100644
index 000000000..d5e05f25f
--- /dev/null
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/controller/AppointmentController.java
@@ -0,0 +1,37 @@
+package com.openhis.web.outpatient.controller;
+
+import com.openhis.web.outpatient.service.AppointmentService;
+import org.springframework.web.bind.annotation.*;
+
+import java.util.Map;
+
+/**
+ * 门诊预约相关接口
+ *
+ * 新增：/confirm 接口用于预约签到缴费成功后状态流转（Bug #574）
+ */
+@RestController
+@RequestMapping("/api/outpatient/appointment")
+public class AppointmentController {
+
+    private final AppointmentService appointmentService;
+
+    public AppointmentController(AppointmentService appointmentService) {
+        this.appointmentService = appointmentService;
+    }
+
+    @PostMapping("/book")
+    public Map<String, Object> book(@RequestParam Long slotId, @RequestParam Long orderId) {
+        appointmentService.bookSlot(slotId, orderId);
+        return Map.of("success", true);
+    }
+
+    /**
+     * 预约签到缴费成功后调用
+     */
+    @PostMapping("/confirm")
+    public Map<String, Object> confirm(@RequestParam Long slotId) {
+        appointmentService.confirmPaymentAndTake(slotId);
+        return Map.of("success", true);
+    }
+}
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/mapper/AppointmentSlotMapper.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/mapper/AppointmentSlotMapper.java
index 0897bd6d0..7dedadb14 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/mapper/AppointmentSlotMapper.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/mapper/AppointmentSlotMapper.java
@@ -10,6 +10,7 @@ import java.util.Map;
 /**
  * 门诊号源预约 Mapper
  * 修复 Bug #570：规范号源状态流转，移除“已锁定”状态，确保预约成功后状态正确落库为 2(已预约)
+ * 新增：状态流转至已取号(3) 的接口，解决预约签到缴费成功后状态未及时流转的问题（Bug #574）
  */
 @Mapper
 public interface AppointmentSlotMapper {
@@ -22,6 +23,16 @@ public interface AppointmentSlotMapper {
             "WHERE id = #{slotId} AND status = 1")
     int updateSlotToBooked(@Param("slotId") Long slotId, @Param("orderId") Long orderId);
 
+    /**
+     * 预约签到缴费成功后，将号源状态流转为已取号(3)
+     *
+     * @param slotId 号源主键
+     * @return 受影响行数
+     */
+    @Update("UPDATE adm_schedule_slot SET status = 3, update_time = NOW() " +
+            "WHERE id = #{slotId} AND status = 2")
+    int updateSlotToTaken(@Param("slotId") Long slotId);
+
     /**
      * 根据状态查询号源列表
      * 修复点：支持按 status=2 精确查询，兼容前端“已预约”筛选条件
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/AppointmentService.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/AppointmentService.java
new file mode 100644
index 000000000..d8664ba63
--- /dev/null
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/AppointmentService.java
@@ -0,0 +1,24 @@
+package com.openhis.web.outpatient.service;
+
+/**
+ * 门诊预约业务接口
+ *
+ * 新增：confirmPaymentAndTake 用于处理预约签到缴费成功后状态流转（Bug #574）
+ */
+public interface AppointmentService {
+
+    /**
+     * 预约号源
+     *
+     * @param slotId 号源ID
+     * @param orderId 预约订单ID
+     */
+    void bookSlot(Long slotId, Long orderId);
+
+    /**
+     * 预约签到缴费成功后，将号源状态更新为已取号(3)
+     *
+     * @param slotId 号源ID
+     */
+    void confirmPaymentAndTake(Long slotId);
+}
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/AppointmentServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/AppointmentServiceImpl.java
index 84d05674d..bc172ce53 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/AppointmentServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/AppointmentServiceImpl.java
@@ -7,6 +7,7 @@ import org.springframework.transaction.annotation.Transactional;
 /**
  * 门诊预约服务实现
  * 修复 Bug #570：简化预约状态流转，确保事务内直接落库为“已预约”状态
+ * 新增：预约签到缴费成功后状态流转为“已取号”(3) 的业务（Bug #574）
  */
 @Service
 public class AppointmentServiceImpl implements AppointmentService {
@@ -30,4 +31,21 @@ public class AppointmentServiceImpl implements AppointmentService {
             throw new RuntimeException("号源状态异常或已被他人预约，请刷新后重试");
         }
     }
+
+    /**
+     * 预约签到缴费成功后调用，完成状态流转至已取号(3)
+     *
+     * @param slotId 号源主键
+     */
+    @Override
+    @Transactional(rollbackFor = Exception.class)
+    public void confirmPaymentAndTake(Long slotId) {
+        if (slotId == null) {
+            throw new IllegalArgumentException("号源ID不能为空");
+        }
+        int updated = slotMapper.updateSlotToTaken(slotId);
+        if (updated == 0) {
+            throw new RuntimeException("号源状态异常，可能未完成预约或已被其他操作修改");
+        }
+    }
 }