diff --git a/src/api/his.ts b/src/api/his.ts
index 5eb79f0..e0d294c 100644
--- a/src/api/his.ts
+++ b/src/api/his.ts
@@ -16,6 +16,8 @@ import type {
   PhysicalExamSignInResponse,
   InputTongyishuInfo,
   TongyishuGetResponse,
+  InputTongyishuSignSubmit,
+  TongyishuSignSubmitResponse,
 } from './types';
 
 /**
@@ -126,3 +128,23 @@ export const getTongyishuPdf = (
   ).then(res => res.data);
 };
 
+/**
+ * 提交体检知情同意书签名（上传签名图片）
+ */
+export const submitTongyishuSign = (
+  data: InputTongyishuSignSubmit
+): Promise<TongyishuSignSubmitResponse> => {
+  const formData = new FormData();
+  formData.append('sign_file', data.sign_file);
+  
+  return request.post<TongyishuSignSubmitResponse>(
+    `${MEDICAL_EXAM_BASE_PATH}/tongyishu-sign-submit?exam_id=${data.exam_id}&combination_code=${data.combination_code}`,
+    formData,
+    {
+      headers: {
+        'Content-Type': 'multipart/form-data',
+      },
+    }
+  ).then(res => res.data);
+};
+
diff --git a/src/api/types.ts b/src/api/types.ts
index 2b30bc4..cf54970 100644
--- a/src/api/types.ts
+++ b/src/api/types.ts
@@ -307,3 +307,32 @@ export interface OutputTongyishuInfo {
  */
 export type TongyishuGetResponse = CommonActionResult<OutputTongyishuInfo>;
 
+/**
+ * 提交体检知情同意书签名入参
+ */
+export interface InputTongyishuSignSubmit {
+  /** 体检ID */
+  exam_id: number;
+  /** PDF文件组合代码 */
+  combination_code: number;
+  /** 签名图片文件 */
+  sign_file: File | Blob;
+}
+
+/**
+ * 提交体检知情同意书签名出参
+ */
+export interface OutputTongyishuSignInfo {
+  /** 体检知情同意书文件组合代码 */
+  combination_code?: string | null;
+  /** 体检知情同意书PDF地址 */
+  pdf_url?: string | null;
+  /** 消息内容 */
+  message?: string | null;
+}
+
+/**
+ * 提交体检知情同意书签名响应
+ */
+export type TongyishuSignSubmitResponse = CommonActionResult<OutputTongyishuSignInfo>;
+