diff --git a/src/components/exam/ExamModal.tsx b/src/components/exam/ExamModal.tsx
index f8b17ac..564b9ba 100644
--- a/src/components/exam/ExamModal.tsx
+++ b/src/components/exam/ExamModal.tsx
@@ -22,7 +22,7 @@ export const ExamModal = ({ client, tab, onTabChange, onClose }: ExamModalProps)
     { key: 'detail', label: '详情' },
     { key: 'sign', label: '签到' },
     { key: 'addon', label: '加项' },
-    { key: 'print', label: '打印导检单' },
+    // { key: 'print', label: '打印导检单' },
     { key: 'delivery', label: '报告寄送' },
   ];
 
diff --git a/src/components/exam/ExamSection.tsx b/src/components/exam/ExamSection.tsx
index 672ea13..bd02af7 100644
--- a/src/components/exam/ExamSection.tsx
+++ b/src/components/exam/ExamSection.tsx
@@ -266,7 +266,7 @@ export const ExamSection = ({
                           }}
                         >
                           <span>签到</span>
-                          {signDone && <span>✅</span>}
+                          {(signDone && printDone) && <span>✅</span>}
                         </button>
                         <button
                           type='button'
@@ -279,7 +279,7 @@ export const ExamSection = ({
                           <span>加项</span>
                           {addonCount > 0 && <span className='opacity-80'>({addonCount})</span>}
                         </button>
-                        <button
+                        {/* <button
                           type='button'
                           className='px-2 py-0.5 rounded-2xl border bg-white hover:bg-gray-100 flex items-center gap-1'
                           onClick={(e) => {
@@ -289,7 +289,7 @@ export const ExamSection = ({
                         >
                           <span>打印导检单</span>
                           {printDone && <span>✅</span>}
-                        </button>
+                        </button> */}
                         <button
                           type='button'
                           className='px-2 py-0.5 rounded-2xl border bg-white hover:bg-gray-100 flex items-center gap-1'
diff --git a/src/components/exam/ExamSignPanel.tsx b/src/components/exam/ExamSignPanel.tsx
index 760b770..945e9a1 100644
--- a/src/components/exam/ExamSignPanel.tsx
+++ b/src/components/exam/ExamSignPanel.tsx
@@ -3,11 +3,13 @@ import * as pdfjsLib from 'pdfjs-dist';
 import pdfjsWorker from 'pdfjs-dist/build/pdf.worker.min.mjs?url';
 
 import type { OutputTongyishuFileInfo } from '../../api';
-import { getTongyishuPdf, signInMedicalExamCenter, submitTongyishuSign } from '../../api';
+import { getTongyishuPdf, signInMedicalExamCenter, submitTongyishuSign, submitDaojiandanSign, editDaojiandanPrintStatus } from '../../api';
 import {
   setExamActionRecord,
   setTongyishuPdfList,
   getTongyishuPdfList,
+  setDaojiandanPdf,
+  getDaojiandanPdf as getDaojiandanPdfFromStorage,
   type TongyishuPdfInfo,
 } from '../../utils/examActions';
 import type { SignaturePadHandle } from '../ui';
@@ -55,7 +57,16 @@ export const ExamSignPanel = ({ examId, onBusyChange }: ExamSignPanelProps) => {
   const [pdfLoading, setPdfLoading] = useState(false);
   const [pdfBlobUrl, setPdfBlobUrl] = useState<string | null>(null);
   const canvasContainerRef = useRef<HTMLDivElement>(null);
-  const busy = signLoading || submitLoading || consentLoading || pdfLoading;
+
+  // 导检单相关状态
+  const [daojiandanUrl, setDaojiandanUrl] = useState<string | null>(null);
+  const [showDaojiandanSignature, setShowDaojiandanSignature] = useState(false);
+  const daojiandanSignaturePadRef = useRef<SignaturePadHandle | null>(null);
+  const [daojiandanSubmitLoading, setDaojiandanSubmitLoading] = useState(false);
+  const [daojiandanSubmitMessage, setDaojiandanSubmitMessage] = useState<string | null>(null);
+  const [showDaojiandanPreview, setShowDaojiandanPreview] = useState(false);
+
+  const busy = signLoading || submitLoading || consentLoading || pdfLoading || daojiandanSubmitLoading;
 
   useEffect(() => {
     onBusyChange?.(busy);
@@ -282,6 +293,16 @@ export const ExamSignPanel = ({ examId, onBusyChange }: ExamSignPanelProps) => {
       .finally(() => setConsentLoading(false));
   }, [examId]);
 
+  // 组件加载时检查导检单localStorage
+  useEffect(() => {
+    if (!examId) return;
+
+    const storedPdf = getDaojiandanPdfFromStorage(examId);
+    if (storedPdf && storedPdf.pdf_url) {
+      setDaojiandanUrl(storedPdf.pdf_url);
+    }
+  }, [examId]);
+
   // 加载 PDF 数据
   useEffect(() => {
     if (!previewPdf?.pdf_url) {
@@ -538,6 +559,364 @@ export const ExamSignPanel = ({ examId, onBusyChange }: ExamSignPanelProps) => {
     }
   };
 
+  // 导检单签名提交
+  const handleSubmitDaojiandanSign = async () => {
+    if (!examId) {
+      setDaojiandanSubmitMessage('缺少必要信息，无法提交签名');
+      return;
+    }
+
+    const dataUrl = daojiandanSignaturePadRef.current?.toDataURL('image/png');
+    if (!dataUrl) {
+      setDaojiandanSubmitMessage('请先完成签名');
+      return;
+    }
+
+    setDaojiandanSubmitLoading(true);
+    setDaojiandanSubmitMessage(null);
+    try {
+      const blob = await fetch(dataUrl).then((r) => r.blob());
+
+      const res = await submitDaojiandanSign({
+        exam_id: examId,
+        sign_file: blob,
+      });
+
+      if (res.Status === 200 && res.Data?.pdf_url) {
+        setDaojiandanSubmitMessage('签名提交成功');
+        const pdfUrlValue = res.Data.pdf_url;
+        const pdfNameValue = res.Data.pdf_name || '导检单';
+        setDaojiandanUrl(pdfUrlValue);
+
+        // 保存导检单PDF信息到localStorage
+        setDaojiandanPdf(examId, {
+          pdf_name: pdfNameValue,
+          pdf_url: pdfUrlValue,
+        });
+
+        // 记录打印导检单是否签名操作
+        setExamActionRecord(examId, 'printSign', true);
+
+        // 更新导检单打印状态
+        try {
+          await editDaojiandanPrintStatus({ exam_id: examId });
+        } catch (err) {
+          console.error('更新导检单打印状态失败', err);
+        }
+
+        setTimeout(() => {
+          setShowDaojiandanSignature(false);
+          setDaojiandanSubmitMessage(null);
+          daojiandanSignaturePadRef.current?.clear();
+          setShowDaojiandanPreview(true);
+        }, 2000);
+      } else {
+        setDaojiandanSubmitMessage(res.Message || '签名提交失败');
+      }
+    } catch (err) {
+      console.error('提交签名失败', err);
+      setDaojiandanSubmitMessage('签名提交失败，请稍后重试');
+    } finally {
+      setDaojiandanSubmitLoading(false);
+    }
+  };
+
+  // 导检单直接打印
+  const handleDaojiandanDirectPrint = async () => {
+    if (!daojiandanUrl) return;
+
+    try {
+      const response = await fetch(daojiandanUrl);
+      if (!response.ok) throw new Error('获取PDF文件失败');
+      const blob = await response.blob();
+      const arrayBuffer = await blob.arrayBuffer();
+
+      const pdf = await pdfjsLib.getDocument({ data: arrayBuffer }).promise;
+      const scale = 1.2;
+      const canvasImages: string[] = [];
+
+      for (let pageNum = 1; pageNum <= pdf.numPages; pageNum++) {
+        const page = await pdf.getPage(pageNum);
+        const viewport = page.getViewport({ scale });
+
+        const canvas = document.createElement('canvas');
+        const context = canvas.getContext('2d');
+        if (!context) continue;
+
+        canvas.height = viewport.height;
+        canvas.width = viewport.width;
+
+        const renderContext = {
+          canvasContext: context,
+          viewport: viewport,
+        } as any;
+
+        await page.render(renderContext).promise;
+        canvasImages.push(canvas.toDataURL('image/png'));
+      }
+
+      const printWindow = window.open('', '_blank');
+      if (!printWindow) return;
+
+      printWindow.document.write(`
+        <!DOCTYPE html>
+        <html>
+          <head>
+            <title>导检单打印</title>
+            <style>
+              @media print {
+                body {
+                  margin: 0;
+                  padding: 0;
+                }
+                img {
+                  max-width: 100%;
+                  page-break-after: always;
+                  page-break-inside: avoid;
+                }
+                img:last-child {
+                  page-break-after: auto;
+                }
+              }
+              body {
+                margin: 0;
+                padding: 0;
+              }
+              img {
+                display: block;
+                width: 100%;
+                height: auto;
+              }
+            </style>
+          </head>
+          <body>
+      `);
+
+      canvasImages.forEach((imgData) => {
+        printWindow.document.write(`<img src="${imgData}" />`);
+      });
+
+      printWindow.document.write(`
+          </body>
+        </html>
+      `);
+
+      printWindow.document.close();
+
+      // 更新导检单打印状态
+      if (examId) {
+        try {
+          await editDaojiandanPrintStatus({ exam_id: examId });
+        } catch (err) {
+          console.error('更新导检单打印状态失败', err);
+          // 不阻塞打印流程，仅记录错误
+        }
+      }
+
+      printWindow.onload = () => {
+        printWindow.focus();
+        setTimeout(() => {
+          printWindow.print();
+        }, 1000);
+      };
+    } catch (err) {
+      console.error('打印失败', err);
+      alert('打印失败，请稍后重试');
+    }
+  };
+
+  // 检查所有文档是否都已签名
+  const checkAllSigned = () => {
+    // 检查所有知情同意书是否都已签名
+    const allConsentsSigned = consentList.every((item) => {
+      if (item.combination_code === undefined || item.combination_code === null) return true;
+      return signedCombinationCodes.includes(Number(item.combination_code));
+    });
+
+    // 检查导检单是否已签名
+    const daojiandanSigned = !!daojiandanUrl;
+
+    return allConsentsSigned && consentList.length > 0 && daojiandanSigned;
+  };
+
+  // 一键打印所有文档
+  const handleBatchPrint = async () => {
+    if (busy) return;
+
+    try {
+      const allImages: string[] = [];
+      const scale = 1.2;
+
+      // 处理所有已签名的知情同意书
+      for (const item of consentList) {
+        if (item.combination_code === undefined || item.combination_code === null) continue;
+        if (!signedCombinationCodes.includes(Number(item.combination_code))) continue;
+
+        let targetUrl = item.pdf_url;
+
+        // 如果本地已保存签名后的PDF列表，则优先使用签名后的PDF地址
+        if (examId) {
+          const storedList = getTongyishuPdfList(examId);
+          if (storedList && item.combination_code !== undefined && item.combination_code !== null) {
+            const code = Number(item.combination_code);
+            const matched = storedList.find(
+              (pdf) => pdf.combination_code !== null && Number(pdf.combination_code) === code,
+            );
+            if (matched && matched.pdf_url) {
+              targetUrl = matched.pdf_url;
+            }
+          }
+        }
+
+        if (!targetUrl) continue;
+
+        try {
+          const response = await fetch(targetUrl);
+          if (!response.ok) continue;
+          const blob = await response.blob();
+          const arrayBuffer = await blob.arrayBuffer();
+
+          const pdf = await pdfjsLib.getDocument({ data: arrayBuffer }).promise;
+
+          for (let pageNum = 1; pageNum <= pdf.numPages; pageNum++) {
+            const page = await pdf.getPage(pageNum);
+            const viewport = page.getViewport({ scale });
+
+            const canvas = document.createElement('canvas');
+            const context = canvas.getContext('2d');
+            if (!context) continue;
+
+            canvas.height = viewport.height;
+            canvas.width = viewport.width;
+
+            const renderContext = {
+              canvasContext: context,
+              viewport: viewport,
+            } as any;
+
+            await page.render(renderContext).promise;
+            allImages.push(canvas.toDataURL('image/png'));
+          }
+        } catch (err) {
+          console.error(`处理知情同意书 ${item.pdf_name} 失败`, err);
+        }
+      }
+
+      // 处理导检单
+      if (daojiandanUrl) {
+        try {
+          const response = await fetch(daojiandanUrl);
+          if (response.ok) {
+            const blob = await response.blob();
+            const arrayBuffer = await blob.arrayBuffer();
+
+            const pdf = await pdfjsLib.getDocument({ data: arrayBuffer }).promise;
+
+            for (let pageNum = 1; pageNum <= pdf.numPages; pageNum++) {
+              const page = await pdf.getPage(pageNum);
+              const viewport = page.getViewport({ scale });
+
+              const canvas = document.createElement('canvas');
+              const context = canvas.getContext('2d');
+              if (!context) continue;
+
+              canvas.height = viewport.height;
+              canvas.width = viewport.width;
+
+              const renderContext = {
+                canvasContext: context,
+                viewport: viewport,
+              } as any;
+
+              await page.render(renderContext).promise;
+              allImages.push(canvas.toDataURL('image/png'));
+            }
+          }
+        } catch (err) {
+          console.error('处理导检单失败', err);
+        }
+      }
+
+      if (allImages.length === 0) {
+        alert('没有可打印的内容');
+        return;
+      }
+
+      // 创建打印窗口
+      const printWindow = window.open('', '_blank');
+      if (!printWindow) {
+        alert('无法打开打印窗口，请检查浏览器弹窗设置');
+        return;
+      }
+
+      printWindow.document.write(`
+        <!DOCTYPE html>
+        <html>
+          <head>
+            <title>一键打印</title>
+            <style>
+              @media print {
+                body {
+                  margin: 0;
+                  padding: 0;
+                }
+                img {
+                  max-width: 100%;
+                  page-break-after: always;
+                  page-break-inside: avoid;
+                }
+                img:last-child {
+                  page-break-after: auto;
+                }
+              }
+              body {
+                margin: 0;
+                padding: 0;
+              }
+              img {
+                display: block;
+                width: 100%;
+                height: auto;
+              }
+            </style>
+          </head>
+          <body>
+      `);
+
+      allImages.forEach((imgData) => {
+        printWindow.document.write(`<img src="${imgData}" />`);
+      });
+
+      printWindow.document.write(`
+          </body>
+        </html>
+      `);
+
+      printWindow.document.close();
+
+      // 如果包含导检单，更新导检单打印状态
+      if (examId && daojiandanUrl) {
+        try {
+          await editDaojiandanPrintStatus({ exam_id: examId });
+        } catch (err) {
+          console.error('更新导检单打印状态失败', err);
+          // 不阻塞打印流程，仅记录错误
+        }
+      }
+
+      // 等待图片加载完成后执行打印
+      printWindow.onload = () => {
+        printWindow.focus();
+        setTimeout(() => {
+          printWindow.print();
+        }, 1000);
+      };
+    } catch (err) {
+      console.error('一键打印失败', err);
+      alert('一键打印失败，请稍后重试');
+    }
+  };
+
   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'>
@@ -582,12 +961,23 @@ export const ExamSignPanel = ({ examId, onBusyChange }: ExamSignPanelProps) => {
         </div>
       )}
       <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>
+        <div className='flex items-center justify-between'>
+          <div className='font-medium'>体检知情同意书</div>
+          {checkAllSigned() && (
+            <Button
+              className='py-1 px-3 bg-green-600 hover:bg-green-700 text-white text-xs'
+              onClick={handleBatchPrint}
+              disabled={busy}
+            >
+              一键打印
+            </Button>
+          )}
+        </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> */}
         <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 && (
+          {!consentLoading && (consentList.length > 0 || true) && (
             <div className='space-y-2'>
               {consentList.map((item) => (
                 <div
@@ -668,6 +1058,56 @@ export const ExamSignPanel = ({ examId, onBusyChange }: ExamSignPanelProps) => {
                   </div>
                 </div>
               ))}
+              <div className='flex items-center justify-between gap-3 p-2 rounded-xl border bg-white shadow-sm'>
+                <div className='text-sm text-gray-800 truncate flex items-center gap-2 relative pr-20'>
+                  <span className='truncate'>导检单</span>
+                  {daojiandanUrl && (
+                    <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>
+                <div className='flex items-center gap-2'>
+                  {daojiandanUrl ? (
+                    <>
+                      <Button
+                        className='py-1.5 px-3 bg-blue-600 hover:bg-blue-700 text-white'
+                        onClick={() => {
+                          if (busy) return;
+                          handleDaojiandanDirectPrint();
+                        }}
+                        disabled={busy}
+                      >
+                        打印
+                      </Button>
+                      <Button
+                        className='py-1.5 px-3'
+                        onClick={() => {
+                          if (busy) return;
+                          setShowDaojiandanPreview(true);
+                        }}
+                        disabled={busy}
+                      >
+                        查看
+                      </Button>
+                    </>
+                  ) : (
+                    <Button
+                      className='py-1.5 px-3'
+                      onClick={() => {
+                        if (busy) return;
+                        setShowDaojiandanSignature(true);
+                      }}
+                      disabled={busy}
+                    >
+                      签名
+                    </Button>
+                  )}
+                </div>
+              </div>
             </div>
           )}
         </div>
@@ -715,7 +1155,7 @@ export const ExamSignPanel = ({ examId, onBusyChange }: ExamSignPanelProps) => {
         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之间'>
+              <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)} disabled={busy}>
@@ -762,6 +1202,87 @@ export const ExamSignPanel = ({ examId, onBusyChange }: ExamSignPanelProps) => {
           </div>
         )
       }
+      {
+        showDaojiandanSignature && (
+          <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'>签署导检单</div>
+                <div className='flex items-center gap-2'>
+                  <Button className='py-1 px-3' onClick={() => setShowDaojiandanSignature(false)} disabled={busy}>
+                    关闭
+                  </Button>
+                </div>
+              </div>
+              <div className='ui7-signature-wrapper border rounded-xl overflow-hidden bg-gray-50'>
+                <SignaturePad
+                  ref={daojiandanSignaturePadRef}
+                  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</div>
+                  <Button className='ui7-clear-button py-1 px-3' onClick={() => daojiandanSignaturePadRef.current?.clear()} disabled={daojiandanSubmitLoading}>
+                    清除
+                  </Button>
+                </div>
+              </div>
+              {daojiandanSubmitMessage && (
+                <div className={`text-sm text-center ${daojiandanSubmitMessage.includes('成功') ? 'text-green-600' : 'text-amber-600'}`}>{daojiandanSubmitMessage}</div>
+              )}
+              <div className='flex items-center justify-end gap-3'>
+                <Button
+                  className='py-2 px-6'
+                  onClick={() => {
+                    setShowDaojiandanSignature(false);
+                    setDaojiandanSubmitMessage(null);
+                    daojiandanSignaturePadRef.current?.clear();
+                  }}
+                  disabled={daojiandanSubmitLoading}
+                >
+                  取消
+                </Button>
+                <Button
+                  className='py-2 px-6 bg-blue-600 text-white hover:bg-blue-700'
+                  onClick={handleSubmitDaojiandanSign}
+                  disabled={daojiandanSubmitLoading}
+                >
+                  {daojiandanSubmitLoading ? '提交中...' : '提交签名'}
+                </Button>
+              </div>
+            </div>
+          </div>
+        )
+      }
+      {
+        showDaojiandanPreview && daojiandanUrl && (
+          <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'>导检单</div>
+              <div className='flex items-center gap-2'>
+                <Button
+                  className='py-1 px-3 bg-blue-600 hover:bg-blue-700 text-white disabled:opacity-50 disabled:cursor-not-allowed'
+                  onClick={handleDaojiandanDirectPrint}
+                  disabled={busy}
+                >
+                  打印
+                </Button>
+                <Button className='py-1 px-3' onClick={() => !busy && setShowDaojiandanPreview(false)} disabled={busy}>
+                  关闭
+                </Button>
+              </div>
+            </div>
+            <div className='flex-1 bg-gray-100 overflow-auto'>
+              <div className='flex justify-center p-4'>
+                <iframe
+                  src={daojiandanUrl}
+                  className='w-full h-full min-h-[600px] border rounded-lg bg-white'
+                  title='导检单预览'
+                />
+              </div>
+            </div>
+          </div>
+        )
+      }
     </div >
   );
 };