diff --git a/admin/src/views/tcm/diagnosis/index.vue b/admin/src/views/tcm/diagnosis/index.vue
index b5c7b8bb..7f7a3444 100644
--- a/admin/src/views/tcm/diagnosis/index.vue
+++ b/admin/src/views/tcm/diagnosis/index.vue
@@ -152,7 +152,7 @@
                         <div >{{ row.gender_desc || '-' }} · {{ row.age ?? '-' }}岁</div>
                     </template>
                 </el-table-column>
-                <el-table-column label="挂号" min-width="150">
+                <el-table-column label="挂号" min-width="175">
                     <template #default="{ row }">
                         <div
                             class="appointment-cell"
@@ -169,6 +169,17 @@
                                         <div class="apt-badge">{{ appointmentStatusLabelByStatus(apt.status) }}</div>
                                         <div class="apt-doctor">{{ apt.doctor_name || '-' }}</div>
                                         <div class="apt-time">{{ apt.time_text || '-' }}</div>
+                                        <div v-if="canCancelAppointmentItem(apt)" class="apt-actions">
+                                            <el-button
+                                                v-perms="['tcm.diagnosis/guahao']"
+                                                type="danger"
+                                                link
+                                                size="small"
+                                                @click.stop="handleCancelAppointmentItem(row, apt)"
+                                            >
+                                                取消挂号
+                                            </el-button>
+                                        </div>
                                     </div>
                                 </template>
                                 <template v-else>
@@ -304,7 +315,12 @@
                                         </el-dropdown-item>
                                         <el-dropdown-item v-if="isAppointmentActiveForVideo(row) && hasPermission(['tcm.diagnosis/videoQr'])" command="videoQr"><el-icon><Picture /></el-icon>视频二维码</el-dropdown-item>
                                         <el-dropdown-item v-if="hasPermission(['tcm.diagnosis/guahao']) && isAppointmentActiveForVideo(row)" command="confirmQr"><el-icon><Picture /></el-icon>二维码</el-dropdown-item>
-                                        <el-dropdown-item v-if="canCancelAppointmentRow(row) && hasPermission(['tcm.diagnosis/guahao'])" command="cancelApt"><el-icon><CircleClose /></el-icon>取消挂号</el-dropdown-item>
+                                        <el-dropdown-item
+                                            v-if="canCancelAppointmentFromDropdown(row) && hasPermission(['tcm.diagnosis/guahao'])"
+                                            command="cancelApt"
+                                        >
+                                            <el-icon><CircleClose /></el-icon>取消挂号
+                                        </el-dropdown-item>
                                         <el-dropdown-item v-if="hasPermission(['tcm.diagnosis/guahaoLogList'])" command="guahaoLogs"><el-icon><List /></el-icon>挂号日志</el-dropdown-item>
                                         <el-dropdown-item command="order" v-if="hasPermission(['tcm.diagnosis/order'])"><el-icon><Document /></el-icon>创建订单</el-dropdown-item>
                                         <el-dropdown-item v-if="hasPermission(['tcm.diagnosis/delete'])" command="delete" divided><el-icon><Delete /></el-icon><span class="text-danger">删除</span></el-dropdown-item>
@@ -1408,13 +1424,29 @@ const appointmentCellClasses = (row: any) => {
 const isAppointmentActiveForVideo = (row: any) =>
     row.has_appointment && Number(row.appointment_status) === 1
 
-/** 已预约、已过号可取消（后端同步限制） */
+/** 已预约、已过号可取消（后端同步限制），针对行上主字段 */
 const canCancelAppointmentRow = (row: any) => {
     const s = Number(row.appointment_status)
     return !!(row.has_appointment && row.appointment_id && (s === 1 || s === 4))
 }
 
-// 取消挂号
+/** 单条挂号记录是否允许取消（已预约 1 / 已过号 4） */
+const canCancelAppointmentItem = (apt: any) => {
+    const s = Number(apt?.status)
+    return !!(apt?.id && (s === 1 || s === 4))
+}
+
+/**
+ * 「更多」里行级取消：仅当列表只展示一条挂号时可点，避免多条时与主键 appointment_id 不对齐
+ * 多条时在「挂号」列每条旁单独取消
+ */
+const canCancelAppointmentFromDropdown = (row: any) => {
+    if (!canCancelAppointmentRow(row)) return false
+    const rows = appointmentRows(row)
+    return rows.length <= 1
+}
+
+// 取消挂号（行级，唯一一条时）
 const handleCancelAppointment = async (row: any) => {
     if (!canCancelAppointmentRow(row)) {
         const s = Number(row.appointment_status)
@@ -1425,9 +1457,39 @@ const handleCancelAppointment = async (row: any) => {
         }
         return
     }
+    const rows = appointmentRows(row)
+    const target = rows.length === 1 ? rows[0] : null
+    const aptId = target?.id && canCancelAppointmentItem(target) ? target.id : row.appointment_id
     try {
         await feedback.confirm(`确定要取消患者「${row.patient_name}」的挂号吗？`)
-        await cancelAppointment({ id: row.appointment_id })
+        await cancelAppointment({ id: aptId })
+        feedback.msgSuccess('取消挂号成功')
+        getLists()
+        fetchDateCounts()
+        if (guahaoLogDrawerVisible.value && guahaoLogContextRow.value?.id === row.id) {
+            await fetchGuahaoLogs(row.id)
+        }
+    } catch (e: any) {
+        if (e !== 'cancel') feedback.msgError(e?.msg || '取消挂号失败')
+    }
+}
+
+/** 取消指定挂号（多条展示时用） */
+const handleCancelAppointmentItem = async (row: any, apt: any) => {
+    if (!canCancelAppointmentItem(apt)) {
+        const s = Number(apt?.status)
+        if (s === 3) {
+            feedback.msgWarning('已完成就诊，无法取消挂号')
+        } else {
+            feedback.msgWarning('该挂号无法取消')
+        }
+        return
+    }
+    const doc = apt.doctor_name || '—'
+    const t = apt.time_text || '—'
+    try {
+        await feedback.confirm(`确定取消「${doc}」${t} 的挂号吗？（患者：${row.patient_name || '—'}）`)
+        await cancelAppointment({ id: apt.id })
         feedback.msgSuccess('取消挂号成功')
         getLists()
         fetchDateCounts()
@@ -2061,6 +2123,11 @@ onUnmounted(() => {
             margin-top: 2px;
         }
 
+        .apt-actions {
+            margin-top: 4px;
+            line-height: 1.2;
+        }
+
         &.apt-item-active {
             .apt-badge {
                 color: #3a4acc;