diff --git a/src/page-subspecialty/views/modules/formList/reportForm.vue b/src/page-subspecialty/views/modules/formList/reportForm.vue
index 857f0fe..b22e77a 100644
--- a/src/page-subspecialty/views/modules/formList/reportForm.vue
+++ b/src/page-subspecialty/views/modules/formList/reportForm.vue
@@ -6,7 +6,11 @@
       <el-button type="danger" size="small" @click="formDelete">删除</el-button>
     </div>
     <div id="reportForm" style="width: 840px;padding-right: 8px;text-align: left">
-      <div class="flex" style="width: 240px">患者姓名：<el-input v-model="confirmData.patientName" style="flex: 1" /></div>
+      <div class="flex">
+        <div class="flex" style="width: 240px">患者姓名：<el-input v-model="confirmData.patientName" style="flex: 1" /></div>
+        <div class="flex a-c">登记号:<el-input v-model="confirmData.patientId" style="flex: 1" /></div>
+        <div class="flex a-c">年龄:<el-input v-model="confirmData.patientAge" style="flex: 1" />岁</div>
+      </div>
       <table class="treatAction">
         <thead>
           <tr>
@@ -95,13 +99,14 @@ export default {
         fmwOs: '',
         jzNumber: '',
         patientName: '',
+        patientAge: '',
+        patientId: '',
         remark: '',
         operator: '',
         idList: [],
         operateDate: ''
       },
       formData: {
-        patientName: '',
         form: {
           OD: [
             {
@@ -226,6 +231,8 @@ export default {
       if (!res.jzNumber) {
         this.formData = JSON.parse(JSON.stringify(this.originForm))
         this.confirmData.patientName = this.patientDetail.patientName
+        this.confirmData.patientId = this.patientDetail.patientId
+        this.confirmData.patientAge = this.patientDetail.patientAge
         const userData = JSON.parse(window.sessionStorage.getItem('qg-userData'))
         this.confirmData.operator = userData.signImgBase
         this.confirmData.operateDate = this.$moment().format('YYYY-MM-DD')