diff --git a/public/sign.png b/public/sign.png
new file mode 100644
index 0000000..13afac6
Binary files /dev/null and b/public/sign.png differ
diff --git a/src/components/exam/ExamModal.tsx b/src/components/exam/ExamModal.tsx
index 256c34e..a8489e4 100644
--- a/src/components/exam/ExamModal.tsx
+++ b/src/components/exam/ExamModal.tsx
@@ -8,7 +8,7 @@ import type {
   OutputTongyishuFileInfo,
   PhysicalExamProgressItem,
 } from '../../api';
-import { getCustomerDetail, getPhysicalExamProgressDetail, signInMedicalExamCenter, getTongyishuPdf } from '../../api';
+import { getCustomerDetail, getPhysicalExamProgressDetail, signInMedicalExamCenter, getTongyishuPdf, submitTongyishuSign } from '../../api';
 import type { SignaturePadHandle } from '../ui';
 import { Button, Input, SignaturePad } from '../ui';
 
@@ -189,11 +189,31 @@ const ExamSignPanel = ({ examId }: { examId?: number }) => {
   const [previewPdf, setPreviewPdf] = useState<OutputTongyishuFileInfo | null>(null);
   const [showSignature, setShowSignature] = useState(false);
   const signaturePadRef = useRef<SignaturePadHandle | null>(null);
+  const [submitLoading, setSubmitLoading] = useState(false);
+  const [submitMessage, setSubmitMessage] = useState<string | null>(null);
+  const [signedCombinationCodes, setSignedCombinationCodes] = useState<number[]>([]);
+
+  const SIGN_STORAGE_KEY = 'yh_signed_consents';
 
   const handlePickFile = () => {
     fileInputRef.current?.click();
   };
 
+  useEffect(() => {
+    if (typeof window === 'undefined') return;
+    const raw = localStorage.getItem(SIGN_STORAGE_KEY);
+    if (raw) {
+      try {
+        const parsed = JSON.parse(raw);
+        if (Array.isArray(parsed)) {
+          setSignedCombinationCodes(parsed.filter((x) => typeof x === 'number'));
+        }
+      } catch (err) {
+        console.warn('签名记录解析失败', err);
+      }
+    }
+  }, []);
+
   const mockOcr = async (file: File) => {
     // 简单模拟 OCR：提取文件名中的数字，或返回示例身份证
     const match = file.name.match(/\d{6,18}/);
@@ -238,6 +258,61 @@ const ExamSignPanel = ({ examId }: { examId?: number }) => {
     }
   };
 
+  const handleSubmitSign = async () => {
+    if (!examId || !previewPdf?.combination_code) {
+      setSubmitMessage('缺少必要信息，无法提交签名');
+      return;
+    }
+
+    const dataUrl = signaturePadRef.current?.toDataURL('image/png');
+    if (!dataUrl) {
+      setSubmitMessage('请先完成签名');
+      return;
+    }
+
+    setSubmitLoading(true);
+    setSubmitMessage(null);
+    try {
+      // 将 base64 转换为 Blob
+      const blob = await fetch(dataUrl).then(r => r.blob());
+
+      // 提交签名
+      const res = await submitTongyishuSign({
+        exam_id: examId,
+        combination_code: previewPdf.combination_code,
+        sign_file: blob,
+      });
+
+      if (res.Status === 200) {
+        setSubmitMessage('签名提交成功');
+        // 记录已签名的组合代码
+        setSignedCombinationCodes((prev) => {
+          const code = Number(previewPdf.combination_code);
+          if (!Number.isFinite(code)) return prev || [];
+          const next = Array.from(new Set([...(prev || []), code]));
+          if (typeof window !== 'undefined') {
+            localStorage.setItem(SIGN_STORAGE_KEY, JSON.stringify(next));
+          }
+          return next;
+        });
+        // 2秒后关闭弹窗
+        setTimeout(() => {
+          setShowSignature(false);
+          setPreviewPdf(null);
+          setSubmitMessage(null);
+          signaturePadRef.current?.clear();
+        }, 2000);
+      } else {
+        setSubmitMessage(res.Message || '签名提交失败');
+      }
+    } catch (err) {
+      console.error('提交签名失败', err);
+      setSubmitMessage('签名提交失败，请稍后重试');
+    } finally {
+      setSubmitLoading(false);
+    }
+  };
+
   useEffect(() => {
     if (!examId) {
       setConsentList([]);
@@ -311,7 +386,18 @@ const ExamSignPanel = ({ examId }: { examId?: number }) => {
                   key={item.pdf_url || item.pdf_name}
                   className='flex items-center justify-between gap-3 p-3 rounded-xl border bg-white shadow-sm'
                 >
-                  <div className='text-sm text-gray-800 truncate'>{item.pdf_name}</div>
+                  <div className='text-sm text-gray-800 truncate flex items-center gap-2 relative pr-20'>
+                    <span className='truncate'>{item.pdf_name}</span>
+                    {item.combination_code !== undefined &&
+                      signedCombinationCodes.includes(Number(item.combination_code)) && (
+                        <img
+                          src='/sign.png'
+                          alt='已签名'
+                          className='w-16 h-16 absolute right-2 top-1/2 -translate-y-1/2 pointer-events-none select-none'
+                          loading='lazy'
+                        />
+                      )}
+                  </div>
                   <Button className='py-1.5 px-3' onClick={() => setPreviewPdf(item)}>
                     查看
                   </Button>
@@ -372,6 +458,32 @@ const ExamSignPanel = ({ examId }: { examId?: number }) => {
                 </Button>
               </div>
             </div>
+            {submitMessage && (
+              <div className={`text-sm text-center ${submitMessage.includes('成功') ? 'text-green-600' : 'text-amber-600'
+                }`}>
+                {submitMessage}
+              </div>
+            )}
+            <div className='flex items-center justify-end gap-3'>
+              <Button
+                className='py-2 px-6'
+                onClick={() => {
+                  setShowSignature(false);
+                  setSubmitMessage(null);
+                  signaturePadRef.current?.clear();
+                }}
+                disabled={submitLoading}
+              >
+                取消
+              </Button>
+              <Button
+                className='py-2 px-6 bg-blue-600 text-white hover:bg-blue-700'
+                onClick={handleSubmitSign}
+                disabled={submitLoading}
+              >
+                {submitLoading ? '提交中...' : '提交签名'}
+              </Button>
+            </div>
           </div>
         </div>
       )}