diff --git a/Cargo.lock b/Cargo.lock
index bcfaa00..b0eb1a9 100644
--- a/Cargo.lock
+++ b/Cargo.lock
@@ -714,6 +714,26 @@ dependencies = [
  "unicode-segmentation",
 ]
 
+[[package]]
+name = "core-foundation"
+version = "0.9.4"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "91e195e091a93c46f7102ec7818a2aa394e1e1771c3ab4825963fa03e45afb8f"
+dependencies = [
+ "core-foundation-sys",
+ "libc",
+]
+
+[[package]]
+name = "core-foundation"
+version = "0.10.1"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "b2a6cd9ae233e7f62ba4e9353e81a88df7fc8a5987b8d445b4d90c879bd156f6"
+dependencies = [
+ "core-foundation-sys",
+ "libc",
+]
+
 [[package]]
 name = "core-foundation-sys"
 version = "0.8.7"
@@ -1202,6 +1222,7 @@ dependencies = [
  "chrono",
  "erp-core",
  "jsonwebtoken",
+ "reqwest",
  "sea-orm",
  "serde",
  "serde_json",
@@ -1531,6 +1552,21 @@ version = "0.2.0"
 source = "registry+https://github.com/rust-lang/crates.io-index"
 checksum = "77ce24cb58228fbb8aa041425bb1050850ac19177686ea6e0f41a70416f56fdb"
 
+[[package]]
+name = "foreign-types"
+version = "0.3.2"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "f6f339eb8adc052cd2ca78910fda869aefa38d22d5cb648e6485e4d3fc06f3b1"
+dependencies = [
+ "foreign-types-shared",
+]
+
+[[package]]
+name = "foreign-types-shared"
+version = "0.1.1"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "00b0228411908ca8685dba7fc2cdd70ec9990a6e753e89b6ac91a84c40fbaf4b"
+
 [[package]]
 name = "form_urlencoded"
 version = "1.2.2"
@@ -1736,6 +1772,25 @@ version = "0.3.3"
 source = "registry+https://github.com/rust-lang/crates.io-index"
 checksum = "0cc23270f6e1808e30a928bdc84dea0b9b4136a8bc82338574f23baf47bbd280"
 
+[[package]]
+name = "h2"
+version = "0.4.13"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "2f44da3a8150a6703ed5d34e164b875fd14c2cdab9af1252a9a1020bde2bdc54"
+dependencies = [
+ "atomic-waker",
+ "bytes",
+ "fnv",
+ "futures-core",
+ "futures-sink",
+ "http",
+ "indexmap",
+ "slab",
+ "tokio",
+ "tokio-util",
+ "tracing",
+]
+
 [[package]]
 name = "hashbrown"
 version = "0.12.3"
@@ -1901,6 +1956,7 @@ dependencies = [
  "bytes",
  "futures-channel",
  "futures-core",
+ "h2",
  "http",
  "http-body",
  "httparse",
@@ -1909,6 +1965,38 @@ dependencies = [
  "pin-project-lite",
  "smallvec",
  "tokio",
+ "want",
+]
+
+[[package]]
+name = "hyper-rustls"
+version = "0.27.9"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "33ca68d021ef39cf6463ab54c1d0f5daf03377b70561305bb89a8f83aab66e0f"
+dependencies = [
+ "http",
+ "hyper",
+ "hyper-util",
+ "rustls",
+ "tokio",
+ "tokio-rustls",
+ "tower-service",
+]
+
+[[package]]
+name = "hyper-tls"
+version = "0.6.0"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "70206fc6890eaca9fde8a0bf71caa2ddfc9fe045ac9e5c70df101a7dbde866e0"
+dependencies = [
+ "bytes",
+ "http-body-util",
+ "hyper",
+ "hyper-util",
+ "native-tls",
+ "tokio",
+ "tokio-native-tls",
+ "tower-service",
 ]
 
 [[package]]
@@ -1917,13 +2005,23 @@ version = "0.1.20"
 source = "registry+https://github.com/rust-lang/crates.io-index"
 checksum = "96547c2556ec9d12fb1578c4eaf448b04993e7fb79cbaad930a656880a6bdfa0"
 dependencies = [
+ "base64 0.22.1",
  "bytes",
+ "futures-channel",
+ "futures-util",
  "http",
  "http-body",
  "hyper",
+ "ipnet",
+ "libc",
+ "percent-encoding",
  "pin-project-lite",
+ "socket2 0.6.3",
+ "system-configuration",
  "tokio",
  "tower-service",
+ "tracing",
+ "windows-registry",
 ]
 
 [[package]]
@@ -2124,6 +2222,16 @@ version = "2.12.0"
 source = "registry+https://github.com/rust-lang/crates.io-index"
 checksum = "d98f6fed1fde3f8c21bc40a1abb88dd75e67924f9cffc3ef95607bad8017f8e2"
 
+[[package]]
+name = "iri-string"
+version = "0.7.12"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "25e659a4bb38e810ebc252e53b5814ff908a8c58c2a9ce2fae1bbec24cbf4e20"
+dependencies = [
+ "memchr",
+ "serde",
+]
+
 [[package]]
 name = "is_terminal_polyfill"
 version = "1.70.2"
@@ -2190,6 +2298,8 @@ version = "0.3.94"
 source = "registry+https://github.com/rust-lang/crates.io-index"
 checksum = "2e04e2ef80ce82e13552136fabeef8a5ed1f985a96805761cbb9a2c34e7664d9"
 dependencies = [
+ "cfg-if",
+ "futures-util",
  "once_cell",
  "wasm-bindgen",
 ]
@@ -2461,6 +2571,23 @@ dependencies = [
  "version_check",
 ]
 
+[[package]]
+name = "native-tls"
+version = "0.2.18"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "465500e14ea162429d264d44189adc38b199b62b1c21eea9f69e4b73cb03bbf2"
+dependencies = [
+ "libc",
+ "log",
+ "openssl",
+ "openssl-probe",
+ "openssl-sys",
+ "schannel",
+ "security-framework",
+ "security-framework-sys",
+ "tempfile",
+]
+
 [[package]]
 name = "nix"
 version = "0.29.0"
@@ -2579,6 +2706,50 @@ version = "1.70.2"
 source = "registry+https://github.com/rust-lang/crates.io-index"
 checksum = "384b8ab6d37215f3c5301a95a4accb5d64aa607f1fcb26a11b5303878451b4fe"
 
+[[package]]
+name = "openssl"
+version = "0.10.78"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "f38c4372413cdaaf3cc79dd92d29d7d9f5ab09b51b10dded508fb90bb70b9222"
+dependencies = [
+ "bitflags",
+ "cfg-if",
+ "foreign-types",
+ "libc",
+ "once_cell",
+ "openssl-macros",
+ "openssl-sys",
+]
+
+[[package]]
+name = "openssl-macros"
+version = "0.1.1"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "a948666b637a0f465e8564c73e89d4dde00d72d4d473cc972f390fc3dcee7d9c"
+dependencies = [
+ "proc-macro2",
+ "quote",
+ "syn 2.0.117",
+]
+
+[[package]]
+name = "openssl-probe"
+version = "0.2.1"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "7c87def4c32ab89d880effc9e097653c8da5d6ef28e6b539d313baaacfbafcbe"
+
+[[package]]
+name = "openssl-sys"
+version = "0.9.114"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "13ce1245cd07fcc4cfdb438f7507b0c7e4f3849a69fd84d52374c66d83741bb6"
+dependencies = [
+ "cc",
+ "libc",
+ "pkg-config",
+ "vcpkg",
+]
+
 [[package]]
 name = "ordered-float"
 version = "4.6.0"
@@ -3135,6 +3306,46 @@ dependencies = [
  "bytecheck",
 ]
 
+[[package]]
+name = "reqwest"
+version = "0.12.28"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "eddd3ca559203180a307f12d114c268abf583f59b03cb906fd0b3ff8646c1147"
+dependencies = [
+ "base64 0.22.1",
+ "bytes",
+ "encoding_rs",
+ "futures-core",
+ "h2",
+ "http",
+ "http-body",
+ "http-body-util",
+ "hyper",
+ "hyper-rustls",
+ "hyper-tls",
+ "hyper-util",
+ "js-sys",
+ "log",
+ "mime",
+ "native-tls",
+ "percent-encoding",
+ "pin-project-lite",
+ "rustls-pki-types",
+ "serde",
+ "serde_json",
+ "serde_urlencoded",
+ "sync_wrapper",
+ "tokio",
+ "tokio-native-tls",
+ "tower",
+ "tower-http",
+ "tower-service",
+ "url",
+ "wasm-bindgen",
+ "wasm-bindgen-futures",
+ "web-sys",
+]
+
 [[package]]
 name = "ring"
 version = "0.17.14"
@@ -3349,6 +3560,15 @@ version = "1.0.23"
 source = "registry+https://github.com/rust-lang/crates.io-index"
 checksum = "9774ba4a74de5f7b1c1451ed6cd5285a32eddb5cccb8cc655a4e50009e06477f"
 
+[[package]]
+name = "schannel"
+version = "0.1.29"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "91c1b7e4904c873ef0710c1f407dde2e6287de2bebc1bbbf7d430bb7cbffd939"
+dependencies = [
+ "windows-sys 0.61.2",
+]
+
 [[package]]
 name = "scopeguard"
 version = "1.2.0"
@@ -3526,6 +3746,29 @@ version = "4.1.0"
 source = "registry+https://github.com/rust-lang/crates.io-index"
 checksum = "1c107b6f4780854c8b126e228ea8869f4d7b71260f962fefb57b996b8959ba6b"
 
+[[package]]
+name = "security-framework"
+version = "3.7.0"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "b7f4bc775c73d9a02cde8bf7b2ec4c9d12743edf609006c7facc23998404cd1d"
+dependencies = [
+ "bitflags",
+ "core-foundation 0.10.1",
+ "core-foundation-sys",
+ "libc",
+ "security-framework-sys",
+]
+
+[[package]]
+name = "security-framework-sys"
+version = "2.17.0"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "6ce2691df843ecc5d231c0b14ece2acc3efb62c0a398c7e1d875f3983ce020e3"
+dependencies = [
+ "core-foundation-sys",
+ "libc",
+]
+
 [[package]]
 name = "semver"
 version = "1.0.28"
@@ -4061,6 +4304,9 @@ name = "sync_wrapper"
 version = "1.0.2"
 source = "registry+https://github.com/rust-lang/crates.io-index"
 checksum = "0bf256ce5efdfa370213c1dabab5935a12e49f2c58d15e9eac2870d3b4f27263"
+dependencies = [
+ "futures-core",
+]
 
 [[package]]
 name = "synstructure"
@@ -4073,6 +4319,27 @@ dependencies = [
  "syn 2.0.117",
 ]
 
+[[package]]
+name = "system-configuration"
+version = "0.7.0"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "a13f3d0daba03132c0aa9767f98351b3488edc2c100cda2d2ec2b04f3d8d3c8b"
+dependencies = [
+ "bitflags",
+ "core-foundation 0.9.4",
+ "system-configuration-sys",
+]
+
+[[package]]
+name = "system-configuration-sys"
+version = "0.6.0"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "8e1d1b10ced5ca923a1fcb8d03e96b8d3268065d724548c0211415ff6ac6bac4"
+dependencies = [
+ "core-foundation-sys",
+ "libc",
+]
+
 [[package]]
 name = "system-interface"
 version = "0.27.3"
@@ -4271,6 +4538,26 @@ dependencies = [
  "syn 2.0.117",
 ]
 
+[[package]]
+name = "tokio-native-tls"
+version = "0.3.1"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "bbae76ab933c85776efabc971569dd6119c580d8f5d448769dec1764bf796ef2"
+dependencies = [
+ "native-tls",
+ "tokio",
+]
+
+[[package]]
+name = "tokio-rustls"
+version = "0.26.4"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "1729aa945f29d91ba541258c8df89027d5792d85a8841fb65e8bf0f4ede4ef61"
+dependencies = [
+ "rustls",
+ "tokio",
+]
+
 [[package]]
 name = "tokio-stream"
 version = "0.1.18"
@@ -4422,11 +4709,14 @@ dependencies = [
  "bitflags",
  "bytes",
  "futures-core",
+ "futures-util",
  "http",
  "http-body",
+ "iri-string",
  "pin-project-lite",
  "tokio",
  "tokio-util",
+ "tower",
  "tower-layer",
  "tower-service",
  "tracing",
@@ -4519,6 +4809,12 @@ dependencies = [
  "tracing-serde",
 ]
 
+[[package]]
+name = "try-lock"
+version = "0.2.5"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "e421abadd41a4225275504ea4d6566923418b7f05506fbc9c0fe86ba7396114b"
+
 [[package]]
 name = "typenum"
 version = "1.19.0"
@@ -4697,6 +4993,15 @@ version = "0.9.5"
 source = "registry+https://github.com/rust-lang/crates.io-index"
 checksum = "0b928f33d975fc6ad9f86c8f283853ad26bdd5b10b7f1542aa2fa15e2289105a"
 
+[[package]]
+name = "want"
+version = "0.3.1"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "bfa7760aed19e106de2c7c0b581b509f2f25d3dacaf737cb82ac61bc6d760b0e"
+dependencies = [
+ "try-lock",
+]
+
 [[package]]
 name = "wasi"
 version = "0.11.1+wasi-snapshot-preview1"
@@ -4741,6 +5046,16 @@ dependencies = [
  "wasm-bindgen-shared",
 ]
 
+[[package]]
+name = "wasm-bindgen-futures"
+version = "0.4.67"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "03623de6905b7206edd0a75f69f747f134b7f0a2323392d664448bf2d3c5d87e"
+dependencies = [
+ "js-sys",
+ "wasm-bindgen",
+]
+
 [[package]]
 name = "wasm-bindgen-macro"
 version = "0.2.117"
@@ -5227,6 +5542,16 @@ dependencies = [
  "wast 246.0.2",
 ]
 
+[[package]]
+name = "web-sys"
+version = "0.3.94"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "cd70027e39b12f0849461e08ffc50b9cd7688d942c1c8e3c7b22273236b4dd0a"
+dependencies = [
+ "js-sys",
+ "wasm-bindgen",
+]
+
 [[package]]
 name = "webpki-roots"
 version = "0.26.11"
@@ -5386,6 +5711,17 @@ version = "0.2.1"
 source = "registry+https://github.com/rust-lang/crates.io-index"
 checksum = "f0805222e57f7521d6a62e36fa9163bc891acd422f971defe97d64e70d0a4fe5"
 
+[[package]]
+name = "windows-registry"
+version = "0.6.1"
+source = "registry+https://github.com/rust-lang/crates.io-index"
+checksum = "02752bf7fbdcce7f2a27a742f798510f3e5ad88dbe84871e5168e2120c3d5720"
+dependencies = [
+ "windows-link",
+ "windows-result",
+ "windows-strings",
+]
+
 [[package]]
 name = "windows-result"
 version = "0.4.1"
diff --git a/crates/erp-health/src/dto/patient_dto.rs b/crates/erp-health/src/dto/patient_dto.rs
index ab164a3..081d5b9 100644
--- a/crates/erp-health/src/dto/patient_dto.rs
+++ b/crates/erp-health/src/dto/patient_dto.rs
@@ -31,6 +31,8 @@ pub struct UpdatePatientReq {
     pub emergency_contact_phone: Option<String>,
     pub source: Option<String>,
     pub notes: Option<String>,
+    pub status: Option<String>,
+    pub verification_status: Option<String>,
 }
 
 #[derive(Debug, Clone, Serialize, Deserialize, ToSchema)]
diff --git a/crates/erp-health/src/error.rs b/crates/erp-health/src/error.rs
index 558a40d..c37fd1b 100644
--- a/crates/erp-health/src/error.rs
+++ b/crates/erp-health/src/error.rs
@@ -17,6 +17,21 @@ pub enum HealthError {
     #[error("排班不存在")]
     ScheduleNotFound,
 
+    #[error("体征记录不存在")]
+    VitalSignsNotFound,
+
+    #[error("化验报告不存在")]
+    LabReportNotFound,
+
+    #[error("健康档案不存在")]
+    HealthRecordNotFound,
+
+    #[error("家庭成员不存在")]
+    FamilyMemberNotFound,
+
+    #[error("标签不存在")]
+    TagNotFound,
+
     #[error("排班已满，无法预约")]
     ScheduleFull,
 
@@ -44,6 +59,11 @@ impl From<HealthError> for AppError {
             | HealthError::DoctorNotFound
             | HealthError::AppointmentNotFound
             | HealthError::ScheduleNotFound
+            | HealthError::VitalSignsNotFound
+            | HealthError::LabReportNotFound
+            | HealthError::HealthRecordNotFound
+            | HealthError::FamilyMemberNotFound
+            | HealthError::TagNotFound
             | HealthError::FollowUpTaskNotFound
             | HealthError::ConsultationNotFound => AppError::NotFound(err.to_string()),
             HealthError::ScheduleFull => AppError::Validation(err.to_string()),
diff --git a/crates/erp-health/src/handler/patient_handler.rs b/crates/erp-health/src/handler/patient_handler.rs
index a3f4196..6584a4f 100644
--- a/crates/erp-health/src/handler/patient_handler.rs
+++ b/crates/erp-health/src/handler/patient_handler.rs
@@ -104,6 +104,8 @@ where
         emergency_contact_phone: req.emergency_contact_phone,
         source: req.source,
         notes: req.notes,
+        status: req.status,
+        verification_status: req.verification_status,
     };
     let result = patient_service::update_patient(
         &state, ctx.tenant_id, id, Some(ctx.user_id), update, version,
@@ -281,6 +283,8 @@ pub struct UpdatePatientWithVersion {
     pub emergency_contact_phone: Option<String>,
     pub source: Option<String>,
     pub notes: Option<String>,
+    pub status: Option<String>,
+    pub verification_status: Option<String>,
     pub version: i32,
 }
 
diff --git a/crates/erp-health/src/service/appointment_service.rs b/crates/erp-health/src/service/appointment_service.rs
index 5a20eca..14f19df 100644
--- a/crates/erp-health/src/service/appointment_service.rs
+++ b/crates/erp-health/src/service/appointment_service.rs
@@ -10,8 +10,12 @@ use erp_core::error::check_version;
 use erp_core::types::PaginatedResponse;
 
 use crate::dto::appointment_dto::*;
-use crate::entity::{appointment, doctor_schedule};
+use crate::entity::{appointment, doctor_schedule, patient};
 use crate::error::{HealthError, HealthResult};
+use crate::service::validation::{
+    validate_appointment_type,
+    validate_period_type, validate_schedule_status,
+};
 use crate::state::HealthState;
 
 // ---------------------------------------------------------------------------
@@ -66,6 +70,17 @@ pub async fn create_appointment(
     operator_id: Option<Uuid>,
     req: CreateAppointmentReq,
 ) -> HealthResult<AppointmentResp> {
+    // 校验患者存在
+    patient::Entity::find()
+        .filter(patient::Column::Id.eq(req.patient_id))
+        .filter(patient::Column::TenantId.eq(tenant_id))
+        .filter(patient::Column::DeletedAt.is_null())
+        .one(&state.db)
+        .await?
+        .ok_or(HealthError::PatientNotFound)?;
+
+    if let Some(ref at) = req.appointment_type { validate_appointment_type(at)?; }
+
     // 原子 CAS: 排班名额 +1
     // 使用 raw SQL 实现 CAS 防止超额预约
     let cas_result = doctor_schedule::Entity::update_many()
@@ -99,7 +114,7 @@ pub async fn create_appointment(
         tenant_id: Set(tenant_id),
         patient_id: Set(req.patient_id),
         doctor_id: Set(req.doctor_id),
-        appointment_type: Set(req.appointment_type.unwrap_or_else(|| "regular".to_string())),
+        appointment_type: Set(req.appointment_type.unwrap_or_else(|| "outpatient".to_string())),
         appointment_date: Set(req.appointment_date),
         start_time: Set(req.start_time),
         end_time: Set(req.end_time),
@@ -254,12 +269,14 @@ pub async fn create_schedule(
     req: CreateScheduleReq,
 ) -> HealthResult<ScheduleResp> {
     let now = Utc::now();
+    let period_type = req.period_type.unwrap_or_else(|| "am".to_string());
+    validate_period_type(&period_type)?;
     let active = doctor_schedule::ActiveModel {
         id: Set(Uuid::now_v7()),
         tenant_id: Set(tenant_id),
         doctor_id: Set(req.doctor_id),
         schedule_date: Set(req.schedule_date),
-        period_type: Set(req.period_type.unwrap_or_else(|| "morning".to_string())),
+        period_type: Set(period_type),
         start_time: Set(req.start_time),
         end_time: Set(req.end_time),
         max_appointments: Set(req.max_appointments),
@@ -300,6 +317,8 @@ pub async fn update_schedule(
     let next_ver = check_version(expected_version, model.version)
         .map_err(|_| HealthError::VersionMismatch)?;
 
+    if let Some(ref s) = req.status { validate_schedule_status(s)?; }
+
     let mut active: doctor_schedule::ActiveModel = model.into();
     if let Some(v) = req.start_time { active.start_time = Set(v); }
     if let Some(v) = req.end_time { active.end_time = Set(v); }
diff --git a/crates/erp-health/src/service/consultation_service.rs b/crates/erp-health/src/service/consultation_service.rs
index 9e58411..b488d7f 100644
--- a/crates/erp-health/src/service/consultation_service.rs
+++ b/crates/erp-health/src/service/consultation_service.rs
@@ -10,8 +10,9 @@ use erp_core::error::check_version;
 use erp_core::types::PaginatedResponse;
 
 use crate::dto::consultation_dto::*;
-use crate::entity::{consultation_message, consultation_session};
+use crate::entity::{consultation_message, consultation_session, patient};
 use crate::error::{HealthError, HealthResult};
+use crate::service::validation::{validate_sender_role, validate_content_type, validate_consultation_type};
 use crate::state::HealthState;
 
 // ---------------------------------------------------------------------------
@@ -25,12 +26,25 @@ pub async fn create_session(
     req: CreateSessionReq,
 ) -> HealthResult<SessionResp> {
     let now = Utc::now();
+
+    // 校验患者存在
+    patient::Entity::find()
+        .filter(patient::Column::Id.eq(req.patient_id))
+        .filter(patient::Column::TenantId.eq(tenant_id))
+        .filter(patient::Column::DeletedAt.is_null())
+        .one(&state.db)
+        .await?
+        .ok_or(HealthError::PatientNotFound)?;
+
+    let consultation_type = req.consultation_type.unwrap_or_else(|| "customer_service".to_string());
+    validate_consultation_type(&consultation_type)?;
+
     let active = consultation_session::ActiveModel {
         id: Set(Uuid::now_v7()),
         tenant_id: Set(tenant_id),
         patient_id: Set(req.patient_id),
         doctor_id: Set(req.doctor_id),
-        consultation_type: Set(req.consultation_type.unwrap_or_else(|| "text".to_string())),
+        consultation_type: Set(consultation_type),
         status: Set("waiting".to_string()),
         last_message_at: Set(None),
         unread_count_patient: Set(0),
@@ -113,7 +127,11 @@ pub async fn close_session(
         .filter(consultation_session::Column::Id.eq(session_id))
         .filter(consultation_session::Column::TenantId.eq(tenant_id))
         .filter(consultation_session::Column::DeletedAt.is_null())
-        .filter(consultation_session::Column::Status.eq("active"))
+        .filter(
+            Condition::any()
+                .add(consultation_session::Column::Status.eq("active"))
+                .add(consultation_session::Column::Status.eq("waiting")),
+        )
         .one(&state.db)
         .await?
         .ok_or(HealthError::ConsultationNotFound)?;
@@ -234,6 +252,9 @@ pub async fn create_message(
         .ok_or(HealthError::ConsultationNotFound)?;
 
     let now = Utc::now();
+    validate_sender_role(&req.sender_role)?;
+    let content_type = req.content_type.unwrap_or_else(|| "text".to_string());
+    validate_content_type(&content_type)?;
     let is_patient = req.sender_role == "patient";
     let should_activate = session.status == "waiting";
 
@@ -244,7 +265,7 @@ pub async fn create_message(
         session_id: Set(req.session_id),
         sender_id: Set(req.sender_id),
         sender_role: Set(req.sender_role),
-        content_type: Set(req.content_type.unwrap_or_else(|| "text".to_string())),
+        content_type: Set(content_type),
         content: Set(req.content),
         is_read: Set(false),
         created_at: Set(now),
diff --git a/crates/erp-health/src/service/follow_up_service.rs b/crates/erp-health/src/service/follow_up_service.rs
index fc4fa46..c64d75d 100644
--- a/crates/erp-health/src/service/follow_up_service.rs
+++ b/crates/erp-health/src/service/follow_up_service.rs
@@ -10,8 +10,9 @@ use erp_core::error::check_version;
 use erp_core::types::PaginatedResponse;
 
 use crate::dto::follow_up_dto::*;
-use crate::entity::{follow_up_record, follow_up_task};
+use crate::entity::{follow_up_record, follow_up_task, patient};
 use crate::error::{HealthError, HealthResult};
+use crate::service::validation::validate_follow_up_type;
 use crate::state::HealthState;
 
 // ---------------------------------------------------------------------------
@@ -65,6 +66,18 @@ pub async fn create_task(
     req: CreateFollowUpTaskReq,
 ) -> HealthResult<FollowUpTaskResp> {
     let now = Utc::now();
+
+    validate_follow_up_type(&req.follow_up_type)?;
+
+    // 校验患者存在
+    patient::Entity::find()
+        .filter(patient::Column::Id.eq(req.patient_id))
+        .filter(patient::Column::TenantId.eq(tenant_id))
+        .filter(patient::Column::DeletedAt.is_null())
+        .one(&state.db)
+        .await?
+        .ok_or(HealthError::PatientNotFound)?;
+
     let active = follow_up_task::ActiveModel {
         id: Set(Uuid::now_v7()),
         tenant_id: Set(tenant_id),
@@ -119,6 +132,13 @@ pub async fn update_task(
     let next_ver = check_version(expected_version, model.version)
         .map_err(|_| HealthError::VersionMismatch)?;
 
+    if let Some(ref ft) = req.follow_up_type { validate_follow_up_type(ft)?; }
+
+    // 状态机验证: follow_up_task.status
+    if let Some(ref new_status) = req.status {
+        validate_follow_up_status_transition(&model.status, new_status)?;
+    }
+
     let mut active: follow_up_task::ActiveModel = model.into();
     if let Some(v) = req.assigned_to { active.assigned_to = Set(Some(v)); }
     if let Some(v) = req.follow_up_type { active.follow_up_type = Set(v); }
@@ -301,3 +321,22 @@ pub async fn list_records(
 
     Ok(PaginatedResponse { data, total, page, page_size: limit, total_pages })
 }
+
+/// 随访任务状态机: pending → in_progress/cancelled, in_progress → completed/cancelled
+fn validate_follow_up_status_transition(current: &str, new_status: &str) -> HealthResult<()> {
+    if current == new_status {
+        return Ok(());
+    }
+    let allowed = match current {
+        "pending" => matches!(new_status, "in_progress" | "cancelled"),
+        "in_progress" => matches!(new_status, "completed" | "cancelled"),
+        _ => false,
+    };
+    if allowed {
+        Ok(())
+    } else {
+        Err(HealthError::InvalidStatusTransition(format!(
+            "follow_up_task.status: 不允许从 '{}' 转换到 '{}'", current, new_status
+        )))
+    }
+}
diff --git a/crates/erp-health/src/service/health_data_service.rs b/crates/erp-health/src/service/health_data_service.rs
index b5eb65d..0861061 100644
--- a/crates/erp-health/src/service/health_data_service.rs
+++ b/crates/erp-health/src/service/health_data_service.rs
@@ -10,7 +10,7 @@ use erp_core::error::check_version;
 use erp_core::types::PaginatedResponse;
 
 use crate::dto::health_data_dto::*;
-use crate::entity::{health_record, health_trend, lab_report, vital_signs};
+use crate::entity::{health_record, health_trend, lab_report, patient, vital_signs};
 use crate::error::{HealthError, HealthResult};
 use crate::state::HealthState;
 
@@ -71,6 +71,15 @@ pub async fn create_vital_signs(
     operator_id: Option<Uuid>,
     req: CreateVitalSignsReq,
 ) -> HealthResult<VitalSignsResp> {
+    // 校验患者存在
+    patient::Entity::find()
+        .filter(patient::Column::Id.eq(patient_id))
+        .filter(patient::Column::TenantId.eq(tenant_id))
+        .filter(patient::Column::DeletedAt.is_null())
+        .one(&state.db)
+        .await?
+        .ok_or(HealthError::PatientNotFound)?;
+
     let now = Utc::now();
     let active = vital_signs::ActiveModel {
         id: Set(Uuid::now_v7()),
@@ -122,7 +131,7 @@ pub async fn update_vital_signs(
         .filter(vital_signs::Column::DeletedAt.is_null())
         .one(&state.db)
         .await?
-        .ok_or(HealthError::PatientNotFound)?;
+        .ok_or(HealthError::VitalSignsNotFound)?;
     let next_ver = check_version(expected_version, model.version)
         .map_err(|_| HealthError::VersionMismatch)?;
 
@@ -167,7 +176,7 @@ pub async fn delete_vital_signs(
         .filter(vital_signs::Column::DeletedAt.is_null())
         .one(&state.db)
         .await?
-        .ok_or(HealthError::PatientNotFound)?;
+        .ok_or(HealthError::VitalSignsNotFound)?;
 
     let mut active: vital_signs::ActiveModel = model.into();
     active.deleted_at = Set(Some(Utc::now()));
@@ -271,7 +280,7 @@ pub async fn update_lab_report(
         .filter(lab_report::Column::DeletedAt.is_null())
         .one(&state.db)
         .await?
-        .ok_or(HealthError::PatientNotFound)?;
+        .ok_or(HealthError::LabReportNotFound)?;
     let next_ver = check_version(expected_version, model.version)
         .map_err(|_| HealthError::VersionMismatch)?;
 
@@ -306,7 +315,7 @@ pub async fn delete_lab_report(
         .filter(lab_report::Column::DeletedAt.is_null())
         .one(&state.db)
         .await?
-        .ok_or(HealthError::PatientNotFound)?;
+        .ok_or(HealthError::LabReportNotFound)?;
 
     let mut active: lab_report::ActiveModel = model.into();
     active.deleted_at = Set(Some(Utc::now()));
@@ -403,7 +412,7 @@ pub async fn update_health_record(
         .filter(health_record::Column::DeletedAt.is_null())
         .one(&state.db)
         .await?
-        .ok_or(HealthError::PatientNotFound)?;
+        .ok_or(HealthError::HealthRecordNotFound)?;
     let next_ver = check_version(expected_version, model.version)
         .map_err(|_| HealthError::VersionMismatch)?;
 
@@ -439,7 +448,7 @@ pub async fn delete_health_record(
         .filter(health_record::Column::DeletedAt.is_null())
         .one(&state.db)
         .await?
-        .ok_or(HealthError::PatientNotFound)?;
+        .ok_or(HealthError::HealthRecordNotFound)?;
 
     let mut active: health_record::ActiveModel = model.into();
     active.deleted_at = Set(Some(Utc::now()));
diff --git a/crates/erp-health/src/service/mod.rs b/crates/erp-health/src/service/mod.rs
index 8c47f90..f6e0fe2 100644
--- a/crates/erp-health/src/service/mod.rs
+++ b/crates/erp-health/src/service/mod.rs
@@ -5,3 +5,4 @@ pub mod follow_up_service;
 pub mod health_data_service;
 pub mod patient_service;
 pub mod seed;
+pub mod validation;
diff --git a/crates/erp-health/src/service/patient_service.rs b/crates/erp-health/src/service/patient_service.rs
index 88364c2..9f23b49 100644
--- a/crates/erp-health/src/service/patient_service.rs
+++ b/crates/erp-health/src/service/patient_service.rs
@@ -15,6 +15,7 @@ use crate::entity::patient_family_member;
 use crate::entity::patient_tag_relation;
 use crate::entity::patient_doctor_relation;
 use crate::error::{HealthError, HealthResult};
+use crate::service::validation::{validate_gender, validate_blood_type};
 use crate::state::HealthState;
 
 // ---------------------------------------------------------------------------
@@ -97,6 +98,9 @@ pub async fn create_patient(
     let now = Utc::now();
     let id = Uuid::now_v7();
 
+    if let Some(ref g) = req.gender { validate_gender(g)?; }
+    if let Some(ref bt) = req.blood_type { validate_blood_type(bt)?; }
+
     let active = patient::ActiveModel {
         id: Set(id),
         tenant_id: Set(tenant_id),
@@ -157,6 +161,26 @@ pub async fn update_patient(
     let next_ver = check_version(expected_version, model.version)
         .map_err(|_| HealthError::VersionMismatch)?;
 
+    if let Some(ref g) = req.gender { validate_gender(g)?; }
+    if let Some(ref bt) = req.blood_type { validate_blood_type(bt)?; }
+
+    // 状态机验证: patient.status
+    if let Some(ref new_status) = req.status {
+        validate_status_transition("patient.status", &model.status, new_status, &[
+            ("active", "inactive"),
+            ("active", "deceased"),
+            ("inactive", "active"),
+        ])?;
+    }
+    // 状态机验证: patient.verification_status
+    if let Some(ref new_vs) = req.verification_status {
+        validate_status_transition("patient.verification_status", &model.verification_status, new_vs, &[
+            ("pending", "verified"),
+            ("pending", "rejected"),
+            ("rejected", "pending"),
+        ])?;
+    }
+
     let mut active: patient::ActiveModel = model.into();
 
     if let Some(v) = req.name { active.name = Set(v); }
@@ -170,6 +194,8 @@ pub async fn update_patient(
     if let Some(v) = req.emergency_contact_phone { active.emergency_contact_phone = Set(Some(v)); }
     if let Some(v) = req.source { active.source = Set(Some(v)); }
     if let Some(v) = req.notes { active.notes = Set(Some(v)); }
+    if let Some(ref v) = req.status { active.status = Set(v.clone()); }
+    if let Some(ref v) = req.verification_status { active.verification_status = Set(v.clone()); }
 
     active.updated_at = Set(Utc::now());
     active.updated_by = Set(operator_id);
@@ -177,8 +203,16 @@ pub async fn update_patient(
 
     let updated = active.update(&state.db).await?;
 
+    // 根据状态变更发布不同事件
+    let event_type = if req.status.as_deref() == Some("deceased") {
+        "patient.deceased"
+    } else if req.verification_status.as_deref() == Some("verified") {
+        "patient.verified"
+    } else {
+        "patient.updated"
+    };
     let event = DomainEvent::new(
-        "patient.updated",
+        event_type,
         tenant_id,
         serde_json::json!({ "patient_id": updated.id }),
     );
@@ -398,7 +432,7 @@ pub async fn create_family_member(
 pub async fn update_family_member(
     state: &HealthState,
     tenant_id: Uuid,
-    _patient_id: Uuid,
+    patient_id: Uuid,
     family_member_id: Uuid,
     operator_id: Option<Uuid>,
     req: FamilyMemberReq,
@@ -406,11 +440,12 @@ pub async fn update_family_member(
 ) -> HealthResult<FamilyMemberResp> {
     let model = patient_family_member::Entity::find()
         .filter(patient_family_member::Column::Id.eq(family_member_id))
+        .filter(patient_family_member::Column::PatientId.eq(patient_id))
         .filter(patient_family_member::Column::TenantId.eq(tenant_id))
         .filter(patient_family_member::Column::DeletedAt.is_null())
         .one(&state.db)
         .await?
-        .ok_or(HealthError::PatientNotFound)?;
+        .ok_or(HealthError::FamilyMemberNotFound)?;
 
     let next_ver = check_version(expected_version, model.version)
         .map_err(|_| HealthError::VersionMismatch)?;
@@ -444,17 +479,18 @@ pub async fn update_family_member(
 pub async fn delete_family_member(
     state: &HealthState,
     tenant_id: Uuid,
-    _patient_id: Uuid,
+    patient_id: Uuid,
     family_member_id: Uuid,
     operator_id: Option<Uuid>,
 ) -> HealthResult<()> {
     let model = patient_family_member::Entity::find()
         .filter(patient_family_member::Column::Id.eq(family_member_id))
+        .filter(patient_family_member::Column::PatientId.eq(patient_id))
         .filter(patient_family_member::Column::TenantId.eq(tenant_id))
         .filter(patient_family_member::Column::DeletedAt.is_null())
         .one(&state.db)
         .await?
-        .ok_or(HealthError::PatientNotFound)?;
+        .ok_or(HealthError::FamilyMemberNotFound)?;
 
     let mut active: patient_family_member::ActiveModel = model.into();
     active.deleted_at = Set(Some(Utc::now()));
@@ -563,3 +599,23 @@ fn model_to_resp(m: patient::Model) -> PatientResp {
         version: m.version,
     }
 }
+
+/// 状态机转换校验: 检查 (current → new) 是否在 allowed_transitions 中
+fn validate_status_transition(
+    field_name: &str,
+    current: &str,
+    new_status: &str,
+    allowed_transitions: &[(&str, &str)],
+) -> HealthResult<()> {
+    if current == new_status {
+        return Ok(());
+    }
+    if allowed_transitions.iter().any(|(from, to)| *from == current && *to == new_status) {
+        Ok(())
+    } else {
+        Err(HealthError::InvalidStatusTransition(format!(
+            "{}: 不允许从 '{}' 转换到 '{}'",
+            field_name, current, new_status
+        )))
+    }
+}
diff --git a/crates/erp-health/src/service/validation.rs b/crates/erp-health/src/service/validation.rs
new file mode 100644
index 0000000..406fa19
--- /dev/null
+++ b/crates/erp-health/src/service/validation.rs
@@ -0,0 +1,108 @@
+//! 通用字段校验 — 枚举白名单、输入格式校验
+
+use crate::error::{HealthError, HealthResult};
+
+macro_rules! validate_enum {
+    ($value:expr, $field:expr, [$($allowed:expr),* $(,)?]) => {
+        {
+            let v: &str = $value;
+            let allowed: &[&str] = &[$($allowed),*];
+            let mut found = false;
+            let mut _i = 0;
+            while _i < allowed.len() {
+                if allowed[_i] == v {
+                    found = true;
+                    break;
+                }
+                _i += 1;
+            }
+            if !found {
+                return Err(HealthError::Validation(format!(
+                    "{}: '{}' 不是有效值，允许值: [{}]",
+                    $field, v, allowed.join(", ")
+                )));
+            }
+        }
+    };
+}
+
+/// patient.gender
+pub fn validate_gender(value: &str) -> HealthResult<()> {
+    validate_enum!(value, "gender", ["male", "female", "other"]);
+    Ok(())
+}
+
+/// patient.blood_type
+pub fn validate_blood_type(value: &str) -> HealthResult<()> {
+    validate_enum!(value, "blood_type", [
+        "A", "B", "AB", "O", "A+", "A-", "B+", "B-", "AB+", "AB-", "O+", "O-",
+    ]);
+    Ok(())
+}
+
+/// appointment.appointment_type
+pub fn validate_appointment_type(value: &str) -> HealthResult<()> {
+    validate_enum!(value, "appointment_type", [
+        "dialysis", "recheck", "outpatient", "health_checkup", "consultation",
+    ]);
+    Ok(())
+}
+
+/// appointment.status transitions
+pub fn validate_appointment_status_transition(current: &str, new: &str) -> HealthResult<()> {
+    if current == new {
+        return Ok(());
+    }
+    let allowed = match current {
+        "pending" => matches!(new, "confirmed" | "cancelled"),
+        "confirmed" => matches!(new, "completed" | "cancelled" | "no_show"),
+        _ => false,
+    };
+    if allowed {
+        Ok(())
+    } else {
+        Err(HealthError::InvalidStatusTransition(format!(
+            "appointment.status: 不允许从 '{}' 转换到 '{}'", current, new
+        )))
+    }
+}
+
+/// doctor_schedule.period_type
+pub fn validate_period_type(value: &str) -> HealthResult<()> {
+    validate_enum!(value, "period_type", ["am", "pm", "night", "full_day"]);
+    Ok(())
+}
+
+/// doctor_schedule.status
+pub fn validate_schedule_status(value: &str) -> HealthResult<()> {
+    validate_enum!(value, "schedule.status", ["enabled", "disabled"]);
+    Ok(())
+}
+
+/// follow_up_task.follow_up_type
+pub fn validate_follow_up_type(value: &str) -> HealthResult<()> {
+    validate_enum!(value, "follow_up_type", [
+        "phone", "wechat", "visit", "sms", "other",
+    ]);
+    Ok(())
+}
+
+/// consultation.sender_role
+pub fn validate_sender_role(value: &str) -> HealthResult<()> {
+    validate_enum!(value, "sender_role", ["patient", "doctor", "system"]);
+    Ok(())
+}
+
+/// consultation.content_type
+pub fn validate_content_type(value: &str) -> HealthResult<()> {
+    validate_enum!(value, "content_type", ["text", "image", "voice", "file"]);
+    Ok(())
+}
+
+/// consultation.consultation_type
+pub fn validate_consultation_type(value: &str) -> HealthResult<()> {
+    validate_enum!(value, "consultation_type", [
+        "customer_service", "doctor", "nutritionist", "psychologist",
+    ]);
+    Ok(())
+}