diff --git a/src/components/exam/ExamModal.tsx b/src/components/exam/ExamModal.tsx
index c2790d4..256c34e 100644
--- a/src/components/exam/ExamModal.tsx
+++ b/src/components/exam/ExamModal.tsx
@@ -5,10 +5,12 @@ import type {
   CustomerAppointmentInfo,
   CustomerExamAddItem,
   CustomerInfo,
+  OutputTongyishuFileInfo,
   PhysicalExamProgressItem,
 } from '../../api';
 import { getCustomerDetail, getPhysicalExamProgressDetail, signInMedicalExamCenter, getTongyishuPdf } from '../../api';
-import { Button, Input } from '../ui';
+import type { SignaturePadHandle } from '../ui';
+import { Button, Input, SignaturePad } from '../ui';
 
 interface ExamModalProps {
   client: ExamClient;
@@ -164,7 +166,7 @@ export const ExamModal = ({ client, tab, onTabChange, onClose }: ExamModalProps)
               loading={detailLoading}
             />
           )}
-          {tab === 'sign' && <ExamSignPanel />}
+          {tab === 'sign' && <ExamSignPanel examId={Number(client.id)} />}
           {tab === 'addon' && <ExamAddonPanel client={client} />}
           {tab === 'print' && <ExamPrintPanel client={client} />}
           {tab === 'delivery' && <ExamDeliveryPanel client={client} />}
@@ -175,12 +177,18 @@ export const ExamModal = ({ client, tab, onTabChange, onClose }: ExamModalProps)
   );
 };
 
-const ExamSignPanel = () => {
+const ExamSignPanel = ({ examId }: { examId?: number }) => {
   const [idNo, setIdNo] = useState('');
   const [ocrLoading, setOcrLoading] = useState(false);
   const [signLoading, setSignLoading] = useState(false);
   const [message, setMessage] = useState<string | null>(null);
   const fileInputRef = useRef<HTMLInputElement | null>(null);
+  const [consentList, setConsentList] = useState<OutputTongyishuFileInfo[]>([]);
+  const [consentLoading, setConsentLoading] = useState(false);
+  const [consentMessage, setConsentMessage] = useState<string | null>(null);
+  const [previewPdf, setPreviewPdf] = useState<OutputTongyishuFileInfo | null>(null);
+  const [showSignature, setShowSignature] = useState(false);
+  const signaturePadRef = useRef<SignaturePadHandle | null>(null);
 
   const handlePickFile = () => {
     fileInputRef.current?.click();
@@ -230,6 +238,29 @@ const ExamSignPanel = () => {
     }
   };
 
+  useEffect(() => {
+    if (!examId) {
+      setConsentList([]);
+      setConsentMessage('缺少体检ID，无法获取知情同意书');
+      return;
+    }
+    setConsentLoading(true);
+    setConsentMessage(null);
+    getTongyishuPdf({ exam_id: examId })
+      .then((res) => {
+        const list = res.Data?.list_pdf_url || [];
+        setConsentList(list);
+        if (!list.length) {
+          setConsentMessage(res.Data?.message || '暂无知情同意书');
+        }
+      })
+      .catch((err) => {
+        console.error('获取知情同意书失败', err);
+        setConsentMessage('知情同意书加载失败，请稍后重试');
+      })
+      .finally(() => setConsentLoading(false));
+  }, [examId]);
+
   return (
     <div className='grid grid-cols-2 gap-4 text-sm'>
       <div className='p-4 rounded-2xl border bg-gray-50/60 flex flex-col gap-3'>
@@ -268,8 +299,82 @@ const ExamSignPanel = () => {
       <div className='p-4 rounded-2xl border bg-gray-50/60 flex flex-col gap-3'>
         <div className='font-medium'>体检知情同意书</div>
         <div className='text-xs text-gray-500'>点击后弹出知情同意书全文及签名区域，签署完成后回到签到页面。</div>
-        <Button className='py-1.5 px-3'>打开知情同意书并签署</Button>
+        <div className='flex flex-col gap-2'>
+          {consentLoading && <div className='text-xs text-gray-500'>加载中...</div>}
+          {!consentLoading && consentMessage && (
+            <div className='text-xs text-amber-600'>{consentMessage}</div>
+          )}
+          {!consentLoading && consentList.length > 0 && (
+            <div className='space-y-2'>
+              {consentList.map((item) => (
+                <div
+                  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>
+                  <Button className='py-1.5 px-3' onClick={() => setPreviewPdf(item)}>
+                    查看
+                  </Button>
+                </div>
+              ))}
+            </div>
+          )}
+        </div>
       </div>
+      {previewPdf && (
+        <div className='fixed inset-0 z-[60] bg-black/75 flex flex-col'>
+          <div className='flex items-center justify-between p-4 text-white bg-gray-900/80'>
+            <div className='text-sm font-medium truncate pr-3'>{previewPdf.pdf_name}</div>
+            <div className='flex items-center gap-2'>
+              <Button
+                className='py-1 px-3'
+                onClick={() => setShowSignature(true)}
+              >
+                签到
+              </Button>
+              <Button className='py-1 px-3' onClick={() => setPreviewPdf(null)}>
+                关闭
+              </Button>
+            </div>
+          </div>
+          <div className='flex-1 bg-gray-100'>
+            <iframe
+              src={previewPdf.pdf_url}
+              title={previewPdf.pdf_name}
+              className='w-full h-full'
+            />
+          </div>
+        </div>
+      )}
+      {showSignature && (
+        <div className='fixed inset-0 z-[70] bg-black/80 flex items-center justify-center px-6'>
+          <div className='bg-white rounded-2xl w-full max-w-3xl shadow-2xl p-4 flex flex-col gap-4'>
+            <div className='flex items-center justify-between'>
+              <div className='text-base font-semibold text-gray-900'>签署知情同意书</div>
+              <div className='flex items-center gap-2'>
+                <Button className='py-1 px-3' onClick={() => setShowSignature(false)}>
+                  关闭
+                </Button>
+              </div>
+            </div>
+            <div className='ui7-signature-wrapper border rounded-xl overflow-hidden bg-gray-50'>
+              <SignaturePad
+                ref={signaturePadRef}
+                className='ui7-signature-canvas w-full h-72 bg-white touch-none'
+              />
+              <div className='flex items-center justify-between px-3 py-2 bg-gray-50 border-t'>
+                <div className='text-xs text-gray-500'>请在上方区域签名完成签到</div>
+                <Button
+                  className='ui7-clear-button py-1 px-3'
+                  onClick={() => signaturePadRef.current?.clear()}
+                >
+                  清除
+                </Button>
+              </div>
+            </div>
+          </div>
+        </div>
+      )}
     </div>
   );
 };
diff --git a/src/components/ui/SignaturePad.tsx b/src/components/ui/SignaturePad.tsx
new file mode 100644
index 0000000..3704c96
--- /dev/null
+++ b/src/components/ui/SignaturePad.tsx
@@ -0,0 +1,136 @@
+import { forwardRef, useCallback, useEffect, useImperativeHandle, useRef } from 'react';
+import type { PointerEvent as ReactPointerEvent } from 'react';
+
+import { cls } from '../../utils/cls';
+
+export interface SignaturePadHandle {
+    clear: () => void;
+    toDataURL: (type?: string, quality?: number) => string | undefined;
+}
+
+interface SignaturePadProps {
+    className?: string;
+    lineWidth?: number;
+    strokeStyle?: string;
+    onDrawEnd?: (dataUrl: string) => void;
+}
+
+export const SignaturePad = forwardRef<SignaturePadHandle, SignaturePadProps>(
+    ({ className = '', lineWidth = 5, strokeStyle = '#111827', onDrawEnd }, ref) => {
+        const canvasRef = useRef<HTMLCanvasElement | null>(null);
+        const isDrawingRef = useRef(false);
+        const lastPointRef = useRef<{ x: number; y: number } | null>(null);
+        const scaleRef = useRef({ scaleX: 1, scaleY: 1 });
+
+        const resizeCanvas = useCallback(() => {
+            const canvas = canvasRef.current;
+            if (!canvas) return;
+            const rect = canvas.getBoundingClientRect();
+            const dpr = window.devicePixelRatio || 1;
+            canvas.width = rect.width * dpr;
+            canvas.height = rect.height * dpr;
+            const ctx = canvas.getContext('2d');
+            if (!ctx) return;
+            ctx.scale(dpr, dpr);
+            ctx.lineWidth = lineWidth;
+            ctx.lineCap = 'round';
+            ctx.strokeStyle = strokeStyle;
+            scaleRef.current = { scaleX: dpr, scaleY: dpr };
+        }, [lineWidth, strokeStyle]);
+
+        useEffect(() => {
+            resizeCanvas();
+            const handleResize = () => resizeCanvas();
+            window.addEventListener('resize', handleResize);
+            return () => window.removeEventListener('resize', handleResize);
+        }, [resizeCanvas]);
+
+        const getPoint = useCallback((e: ReactPointerEvent<HTMLCanvasElement>) => {
+            const canvas = canvasRef.current;
+            if (!canvas) return { x: 0, y: 0 };
+            const rect = canvas.getBoundingClientRect();
+            return {
+                // 使用 CSS 像素坐标，避免与 ctx.scale 的 DPR 缩放重复，防止漂移
+                x: e.clientX - rect.left,
+                y: e.clientY - rect.top,
+            };
+        }, []);
+
+        const startDrawing = useCallback(
+            (e: ReactPointerEvent<HTMLCanvasElement>) => {
+                const canvas = canvasRef.current;
+                if (!canvas) return;
+                isDrawingRef.current = true;
+                lastPointRef.current = getPoint(e);
+                canvas.setPointerCapture(e.pointerId);
+            },
+            [getPoint],
+        );
+
+        const draw = useCallback(
+            (e: ReactPointerEvent<HTMLCanvasElement>) => {
+                if (!isDrawingRef.current) return;
+                const canvas = canvasRef.current;
+                if (!canvas) return;
+                const ctx = canvas.getContext('2d');
+                if (!ctx) return;
+                const current = getPoint(e);
+                const last = lastPointRef.current || current;
+                ctx.beginPath();
+                ctx.moveTo(last.x, last.y);
+                ctx.lineTo(current.x, current.y);
+                ctx.stroke();
+                lastPointRef.current = current;
+            },
+            [getPoint],
+        );
+
+        const stopDrawing = useCallback(
+            (e?: ReactPointerEvent<HTMLCanvasElement>) => {
+                if (!isDrawingRef.current) return;
+                isDrawingRef.current = false;
+                lastPointRef.current = null;
+                if (e?.pointerId && canvasRef.current) {
+                    canvasRef.current.releasePointerCapture(e.pointerId);
+                }
+                const dataUrl = canvasRef.current?.toDataURL();
+                if (dataUrl && onDrawEnd) {
+                    onDrawEnd(dataUrl);
+                }
+            },
+            [onDrawEnd],
+        );
+
+        const clear = useCallback(() => {
+            const canvas = canvasRef.current;
+            const ctx = canvas?.getContext('2d');
+            if (canvas && ctx) {
+                ctx.clearRect(0, 0, canvas.width, canvas.height);
+            }
+        }, []);
+
+        useImperativeHandle(
+            ref,
+            () => ({
+                clear,
+                toDataURL: (type?: string, quality?: number) => canvasRef.current?.toDataURL(type, quality),
+            }),
+            [clear],
+        );
+
+        return (
+            <canvas
+                ref={canvasRef}
+                className={cls('w-full h-72 bg-white touch-none', className)}
+                onPointerDown={startDrawing}
+                onPointerMove={draw}
+                onPointerUp={stopDrawing}
+                onPointerLeave={stopDrawing}
+                onPointerCancel={stopDrawing}
+            />
+        );
+    },
+);
+
+SignaturePad.displayName = 'SignaturePad';
+
diff --git a/src/components/ui/index.ts b/src/components/ui/index.ts
index 3838e3a..0b9e543 100644
--- a/src/components/ui/index.ts
+++ b/src/components/ui/index.ts
@@ -4,5 +4,6 @@ export * from './Card';
 export * from './InfoCard';
 export * from './Input';
 export * from './Select';
+export * from './SignaturePad';