diff --git a/app/Http/Controllers/Care/AppointmentController.php b/app/Http/Controllers/Care/AppointmentController.php
index 320802d..9cbd2d4 100644
--- a/app/Http/Controllers/Care/AppointmentController.php
+++ b/app/Http/Controllers/Care/AppointmentController.php
@@ -11,7 +11,6 @@ use App\Models\Patient;
 use App\Models\Practitioner;
 use App\Services\Care\AppointmentService;
 use App\Services\Care\OrganizationResolver;
-use App\Services\Care\ServiceQueuePresenter;
 use Illuminate\Http\RedirectResponse;
 use Illuminate\Http\Request;
 use Illuminate\View\View;
@@ -22,7 +21,6 @@ class AppointmentController extends Controller
 
     public function __construct(
         protected AppointmentService $appointments,
-        protected ServiceQueuePresenter $serviceQueues,
     ) {}
 
     public function index(Request $request): View
@@ -61,13 +59,6 @@ class AppointmentController extends Controller
             'practitioners' => $practitioners,
             'statuses' => config('care.appointment_statuses'),
             'heroStats' => $heroStats,
-            'serviceQueuePanel' => $this->serviceQueues->panel(
-                $request,
-                $organization,
-                $member,
-                'clinical',
-                $request->input('counter_uuid'),
-            ),
         ]);
     }
 
diff --git a/app/Http/Controllers/Care/BillController.php b/app/Http/Controllers/Care/BillController.php
index 016d970..870e450 100644
--- a/app/Http/Controllers/Care/BillController.php
+++ b/app/Http/Controllers/Care/BillController.php
@@ -7,6 +7,8 @@ use App\Http\Controllers\Care\Concerns\ScopesToAccount;
 use App\Models\Bill;
 use App\Models\Visit;
 use App\Services\Care\BillService;
+use App\Services\Care\CareQueueBridge;
+use App\Services\Care\CareQueueContexts;
 use App\Services\Care\OrganizationResolver;
 use App\Services\Payments\MerchantGatewayService;
 use Illuminate\Http\RedirectResponse;
@@ -21,13 +23,15 @@ class BillController extends Controller
     public function __construct(
         protected BillService $bills,
         protected MerchantGatewayService $gateway,
+        protected CareQueueBridge $queueBridge,
     ) {}
 
     public function index(Request $request): View
     {
         $this->authorizeAbility($request, 'bills.view');
         $organization = $this->organization($request);
-        $branchScope = app(OrganizationResolver::class)->branchScope($this->member($request));
+        $member = $this->member($request);
+        $branchScope = app(OrganizationResolver::class)->branchScope($member);
 
         $bills = $this->bills->list(
             $this->ownerRef($request),
@@ -36,13 +40,59 @@ class BillController extends Controller
             $branchScope,
         );
 
+        $branchId = (int) ($branchScope ?: \App\Models\Branch::owned($this->ownerRef($request))
+            ->where('organization_id', $organization->id)
+            ->where('is_active', true)
+            ->orderBy('name')
+            ->value('id'));
+
         return view('care.bills.index', [
             'organization' => $organization,
             'bills' => $bills,
             'statuses' => config('care.bill_statuses'),
+            'branchId' => $branchId,
+            'queueIntegration' => $branchId
+                ? $this->queueBridge->listMeta($organization, CareQueueContexts::BILLING, $branchId)
+                : ['enabled' => false],
+            'canManageQueue' => app(\App\Services\Care\CarePermissions::class)
+                ->can($member, 'service_queues.console'),
         ]);
     }
 
+    public function callNext(Request $request): RedirectResponse
+    {
+        $this->authorizeAbility($request, 'bills.manage');
+        $organization = $this->organization($request);
+        $member = $this->member($request);
+        $branchScope = app(OrganizationResolver::class)->branchScope($member);
+        $branchId = (int) ($request->input('branch_id') ?: $branchScope);
+        abort_unless($branchId > 0, 422);
+        abort_unless($this->queueBridge->isEnabled($organization), 404);
+
+        $result = $this->queueBridge->callNext($organization, CareQueueContexts::BILLING, $branchId);
+        $ticket = $result['ticket'] ?? null;
+        if (! $ticket) {
+            return back()->with('error', 'No bills waiting in the billing queue.');
+        }
+
+        return back()->with('success', 'Called '.$ticket['ticket_number'].'.');
+    }
+
+    public function serve(Request $request, Bill $bill): RedirectResponse
+    {
+        $this->authorizeAbility($request, 'bills.manage');
+        $this->authorizeBill($request, $bill);
+        $organization = $this->organization($request);
+        abort_unless($this->queueBridge->isEnabled($organization), 404);
+
+        $ticket = $this->queueBridge->serve($organization, $bill);
+        if (! $ticket) {
+            return back()->with('error', 'Could not serve billing ticket.');
+        }
+
+        return back()->with('success', 'Now serving '.$ticket['ticket_number'].'.');
+    }
+
     public function generate(Request $request, Visit $visit): RedirectResponse
     {
         $this->authorizeAbility($request, 'bills.manage');
diff --git a/app/Http/Controllers/Care/DashboardController.php b/app/Http/Controllers/Care/DashboardController.php
index b5a1009..007cbd1 100644
--- a/app/Http/Controllers/Care/DashboardController.php
+++ b/app/Http/Controllers/Care/DashboardController.php
@@ -12,7 +12,6 @@ use App\Services\Care\AppointmentService;
 use App\Services\Care\CarePermissions;
 use App\Services\Care\OrganizationResolver;
 use App\Services\Care\ReportService;
-use App\Services\Care\ServiceQueuePresenter;
 use App\Services\Care\SpecialtyModuleService;
 use Illuminate\Http\Request;
 use Illuminate\Support\Collection;
@@ -26,7 +25,6 @@ class DashboardController extends Controller
         protected ReportService $reports,
         protected CarePermissions $permissions,
         protected AppointmentService $appointments,
-        protected ServiceQueuePresenter $serviceQueues,
         protected SpecialtyModuleService $specialtyModules,
     ) {}
 
@@ -80,12 +78,6 @@ class DashboardController extends Controller
             ? $this->patientQueueForMember($request, $organization->id, $owner, $member, $branchScope)
             : [collect(), collect(), null];
 
-        $serviceQueueContext = match ($member?->role) {
-            'pharmacist' => 'pharmacy',
-            'lab_technician' => 'laboratory',
-            default => 'clinical',
-        };
-
         return view('care.dashboard', [
             'organization' => $organization,
             'member' => $member,
@@ -103,13 +95,6 @@ class DashboardController extends Controller
             'patientQueue' => $queue,
             'inConsultation' => $inConsultation,
             'practitionerId' => $practitionerId,
-            'serviceQueuePanel' => $this->serviceQueues->panel(
-                $request,
-                $organization,
-                $member,
-                $serviceQueueContext,
-                $request->input('counter_uuid'),
-            ),
             'specialtyModules' => $this->specialtyModules->enabledModules($organization),
         ]);
     }
diff --git a/app/Http/Controllers/Care/InvestigationController.php b/app/Http/Controllers/Care/InvestigationController.php
index 71f2987..f875d21 100644
--- a/app/Http/Controllers/Care/InvestigationController.php
+++ b/app/Http/Controllers/Care/InvestigationController.php
@@ -9,9 +9,10 @@ use App\Models\Consultation;
 use App\Models\InvestigationRequest;
 use App\Models\InvestigationType;
 use App\Models\Member;
+use App\Services\Care\CareQueueBridge;
+use App\Services\Care\CareQueueContexts;
 use App\Services\Care\InvestigationService;
 use App\Services\Care\OrganizationResolver;
-use App\Services\Care\ServiceQueuePresenter;
 use Illuminate\Http\RedirectResponse;
 use Illuminate\Http\Request;
 use Illuminate\View\View;
@@ -22,7 +23,7 @@ class InvestigationController extends Controller
 
     public function __construct(
         protected InvestigationService $investigations,
-        protected ServiceQueuePresenter $serviceQueues,
+        protected CareQueueBridge $queueBridge,
     ) {}
 
     public function index(Request $request): View
@@ -76,16 +77,46 @@ class InvestigationController extends Controller
                 ->where('organization_id', $organization->id)
                 ->orderBy('role')
                 ->get(),
-            'serviceQueuePanel' => $this->serviceQueues->panel(
-                $request,
-                $organization,
-                $this->member($request),
-                'laboratory',
-                $request->input('counter_uuid'),
-            ),
+            'queueIntegration' => $branchId
+                ? $this->queueBridge->listMeta($organization, CareQueueContexts::LABORATORY, $branchId)
+                : ['enabled' => false],
         ]);
     }
 
+    public function callNext(Request $request): RedirectResponse
+    {
+        $this->authorizeAbility($request, 'lab.manage');
+        $organization = $this->organization($request);
+        $member = $this->member($request);
+        $branchScope = app(OrganizationResolver::class)->branchScope($member);
+        $branchId = (int) ($request->input('branch_id') ?: $branchScope);
+        abort_unless($branchId > 0, 422);
+        abort_unless($this->queueBridge->isEnabled($organization), 404);
+
+        $result = $this->queueBridge->callNext($organization, CareQueueContexts::LABORATORY, $branchId);
+        $ticket = $result['ticket'] ?? null;
+        if (! $ticket) {
+            return back()->with('error', 'No lab work waiting in the laboratory queue.');
+        }
+
+        return back()->with('success', 'Called '.$ticket['ticket_number'].'.');
+    }
+
+    public function serve(Request $request, InvestigationRequest $investigation): RedirectResponse
+    {
+        $this->authorizeAbility($request, 'lab.manage');
+        $this->authorizeInvestigation($request, $investigation);
+        $organization = $this->organization($request);
+        abort_unless($this->queueBridge->isEnabled($organization), 404);
+
+        $ticket = $this->queueBridge->serve($organization, $investigation);
+        if (! $ticket) {
+            return back()->with('error', 'Could not serve lab ticket.');
+        }
+
+        return back()->with('success', 'Now serving '.$ticket['ticket_number'].'.');
+    }
+
     public function requestFromConsultation(Request $request, Consultation $consultation): RedirectResponse
     {
         $this->authorizeAbility($request, 'investigations.request');
diff --git a/app/Http/Controllers/Care/PrescriptionController.php b/app/Http/Controllers/Care/PrescriptionController.php
index ec6d598..4f827d4 100644
--- a/app/Http/Controllers/Care/PrescriptionController.php
+++ b/app/Http/Controllers/Care/PrescriptionController.php
@@ -7,10 +7,11 @@ use App\Http\Controllers\Care\Concerns\ScopesToAccount;
 use App\Models\Consultation;
 use App\Models\Prescription;
 use App\Models\Practitioner;
+use App\Services\Care\CareQueueBridge;
+use App\Services\Care\CareQueueContexts;
 use App\Services\Care\OrganizationResolver;
 use App\Services\Care\PharmacyService;
 use App\Services\Care\PrescriptionService;
-use App\Services\Care\ServiceQueuePresenter;
 use Illuminate\Http\RedirectResponse;
 use Illuminate\Http\Request;
 use Illuminate\View\View;
@@ -22,7 +23,7 @@ class PrescriptionController extends Controller
     public function __construct(
         protected PrescriptionService $prescriptions,
         protected PharmacyService $pharmacy,
-        protected ServiceQueuePresenter $serviceQueues,
+        protected CareQueueBridge $queueBridge,
     ) {}
 
     public function index(Request $request): View
@@ -49,8 +50,18 @@ class PrescriptionController extends Controller
     {
         $this->authorizeAbility($request, 'prescriptions.view');
         $organization = $this->organization($request);
+        $member = $this->member($request);
+        $branchScope = app(OrganizationResolver::class)->branchScope($member);
+        $branchId = (int) ($branchScope ?: \App\Models\Branch::owned($this->ownerRef($request))
+            ->where('organization_id', $organization->id)
+            ->where('is_active', true)
+            ->orderBy('name')
+            ->value('id'));
 
         $queue = $this->prescriptions->pharmacyQueue($this->ownerRef($request), $organization->id);
+        if ($branchScope) {
+            $queue = $queue->filter(fn (Prescription $rx) => (int) ($rx->visit?->branch_id) === $branchScope)->values();
+        }
 
         $drugs = \App\Models\Drug::owned($this->ownerRef($request))
             ->where('organization_id', $organization->id)
@@ -60,23 +71,54 @@ class PrescriptionController extends Controller
             ->get();
 
         $canDispense = app(\App\Services\Care\CarePermissions::class)
-            ->can($this->member($request), 'prescriptions.dispense');
+            ->can($member, 'prescriptions.dispense');
 
         return view('care.prescriptions.queue', [
             'organization' => $organization,
             'queue' => $queue,
             'drugs' => $drugs,
             'canDispense' => $canDispense,
-            'serviceQueuePanel' => $this->serviceQueues->panel(
-                $request,
-                $organization,
-                $this->member($request),
-                'pharmacy',
-                $request->input('counter_uuid'),
-            ),
+            'branchId' => $branchId,
+            'queueIntegration' => $branchId
+                ? $this->queueBridge->listMeta($organization, CareQueueContexts::PHARMACY, $branchId)
+                : ['enabled' => false],
         ]);
     }
 
+    public function callNext(Request $request): RedirectResponse
+    {
+        $this->authorizeAbility($request, 'prescriptions.dispense');
+        $organization = $this->organization($request);
+        $member = $this->member($request);
+        $branchScope = app(OrganizationResolver::class)->branchScope($member);
+        $branchId = (int) ($request->input('branch_id') ?: $branchScope);
+        abort_unless($branchId > 0, 422);
+        abort_unless($this->queueBridge->isEnabled($organization), 404);
+
+        $result = $this->queueBridge->callNext($organization, CareQueueContexts::PHARMACY, $branchId);
+        $ticket = $result['ticket'] ?? null;
+        if (! $ticket) {
+            return back()->with('error', 'No prescriptions waiting in the pharmacy queue.');
+        }
+
+        return back()->with('success', 'Called '.$ticket['ticket_number'].'.');
+    }
+
+    public function serve(Request $request, Prescription $prescription): RedirectResponse
+    {
+        $this->authorizeAbility($request, 'prescriptions.dispense');
+        $this->authorizePrescription($request, $prescription);
+        $organization = $this->organization($request);
+        abort_unless($this->queueBridge->isEnabled($organization), 404);
+
+        $ticket = $this->queueBridge->serve($organization, $prescription);
+        if (! $ticket) {
+            return back()->with('error', 'Could not serve pharmacy ticket.');
+        }
+
+        return back()->with('success', 'Now serving '.$ticket['ticket_number'].'.');
+    }
+
     public function create(Request $request, Consultation $consultation): View
     {
         $this->authorizeAbility($request, 'prescriptions.manage');
diff --git a/app/Http/Controllers/Care/QueueController.php b/app/Http/Controllers/Care/QueueController.php
index fbbf09b..ffc2e3d 100644
--- a/app/Http/Controllers/Care/QueueController.php
+++ b/app/Http/Controllers/Care/QueueController.php
@@ -8,9 +8,10 @@ use App\Models\Appointment;
 use App\Models\Branch;
 use App\Models\Practitioner;
 use App\Services\Care\AppointmentService;
+use App\Services\Care\CareQueueBridge;
+use App\Services\Care\CareQueueContexts;
 use App\Services\Care\ConsultationService;
 use App\Services\Care\OrganizationResolver;
-use App\Services\Care\ServiceQueuePresenter;
 use Illuminate\Http\RedirectResponse;
 use Illuminate\Http\Request;
 use Illuminate\View\View;
@@ -22,7 +23,7 @@ class QueueController extends Controller
     public function __construct(
         protected AppointmentService $appointments,
         protected ConsultationService $consultations,
-        protected ServiceQueuePresenter $serviceQueues,
+        protected CareQueueBridge $queueBridge,
     ) {}
 
     public function index(Request $request): View
@@ -85,16 +86,47 @@ class QueueController extends Controller
             'canManageQueue' => $canManageQueue,
             'canConsult' => $canConsult,
             'heroStats' => $heroStats,
-            'serviceQueuePanel' => $this->serviceQueues->panel(
-                $request,
-                $organization,
-                $member,
-                'clinical',
-                $request->input('counter_uuid'),
-            ),
+            'queueIntegration' => $branchId
+                ? $this->queueBridge->listMeta($organization, CareQueueContexts::CONSULTATION, $branchId)
+                : ['enabled' => false],
         ]);
     }
 
+    public function callNext(Request $request): RedirectResponse
+    {
+        $this->authorizeAbility($request, 'appointments.view');
+        $organization = $this->organization($request);
+        abort_unless($this->queueBridge->isEnabled($organization), 404);
+
+        $member = $this->member($request);
+        $branchScope = app(OrganizationResolver::class)->branchScope($member);
+        $branchId = (int) ($request->input('branch_id') ?: $branchScope);
+        abort_unless($branchId > 0, 422);
+
+        $result = $this->queueBridge->callNext($organization, CareQueueContexts::CONSULTATION, $branchId);
+        $ticket = $result['ticket'] ?? null;
+        if (! $ticket) {
+            return back()->with('error', 'No patients waiting in the consultation queue.');
+        }
+
+        return back()->with('success', 'Called '.$ticket['ticket_number'].' — '.($ticket['customer_name'] ?? 'patient').'.');
+    }
+
+    public function completeTicket(Request $request, Appointment $appointment): RedirectResponse
+    {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->authorizeAppointment($request, $appointment);
+        $organization = $this->organization($request);
+        abort_unless($this->queueBridge->isEnabled($organization), 404);
+
+        $ticket = $this->queueBridge->complete($organization, $appointment);
+        if (! $ticket) {
+            return back()->with('error', 'Could not complete queue ticket.');
+        }
+
+        return back()->with('success', 'Completed '.$ticket['ticket_number'].'.');
+    }
+
     public function start(Request $request, Appointment $appointment): RedirectResponse
     {
         $this->authorizeAbility($request, 'consultations.manage');
diff --git a/app/Http/Controllers/Care/SettingsController.php b/app/Http/Controllers/Care/SettingsController.php
index b40cd90..70931b7 100644
--- a/app/Http/Controllers/Care/SettingsController.php
+++ b/app/Http/Controllers/Care/SettingsController.php
@@ -9,6 +9,7 @@ use App\Services\Care\AppointmentPatientNotifier;
 use App\Services\Care\AuditLogger;
 use App\Services\Care\CareFeatures;
 use App\Services\Care\CarePermissions;
+use App\Services\Care\CareQueueProvisioner;
 use App\Services\Care\PlanService;
 use App\Services\Billing\PlatformEmailClient;
 use App\Services\Billing\PlatformSmsClient;
@@ -75,7 +76,7 @@ class SettingsController extends Controller
         ]);
     }
 
-    public function update(Request $request, QueueClient $queue): RedirectResponse
+    public function update(Request $request, QueueClient $queue, CareQueueProvisioner $provisioner): RedirectResponse
     {
         $this->authorizeAbility($request, 'settings.manage');
         $organization = $this->organization($request);
@@ -152,6 +153,14 @@ class SettingsController extends Controller
             'settings' => $settings,
         ]);
 
+        if ($wantsQueue && $queue->configured()) {
+            try {
+                $provisioner->provisionOrganization($organization->fresh());
+            } catch (\Throwable) {
+                // Best-effort; role pages will lazy-ensure on next use.
+            }
+        }
+
         AuditLogger::record($owner, 'organization.updated', $organization->id, $owner, \App\Models\Organization::class, $organization->id);
 
         return back()->with('success', 'Settings saved.');
diff --git a/app/Http/Controllers/Care/SpecialtyModuleController.php b/app/Http/Controllers/Care/SpecialtyModuleController.php
index c005c94..f5e1694 100644
--- a/app/Http/Controllers/Care/SpecialtyModuleController.php
+++ b/app/Http/Controllers/Care/SpecialtyModuleController.php
@@ -6,9 +6,10 @@ use App\Http\Controllers\Controller;
 use App\Http\Controllers\Care\Concerns\ScopesToAccount;
 use App\Models\Appointment;
 use App\Models\Department;
+use App\Services\Care\CareQueueBridge;
 use App\Services\Care\OrganizationResolver;
-use App\Services\Care\ServiceQueuePresenter;
 use App\Services\Care\SpecialtyModuleService;
+use Illuminate\Http\RedirectResponse;
 use Illuminate\Http\Request;
 use Illuminate\View\View;
 
@@ -20,7 +21,7 @@ class SpecialtyModuleController extends Controller
         Request $request,
         string $module,
         SpecialtyModuleService $modules,
-        ServiceQueuePresenter $presenter,
+        CareQueueBridge $queueBridge,
     ): View {
         $definition = $modules->definition($module);
         abort_unless($definition, 404);
@@ -59,13 +60,7 @@ class SpecialtyModuleController extends Controller
             ->limit(25)
             ->get();
 
-        $serviceQueuePanel = $presenter->panel(
-            $request,
-            $organization,
-            $member,
-            $module,
-            $request->input('counter_uuid'),
-        );
+        $branchId = (int) ($branchScope ?: $departments->first()?->branch_id);
 
         return view('care.specialty.show', [
             'organization' => $organization,
@@ -74,7 +69,37 @@ class SpecialtyModuleController extends Controller
             'departments' => $departments,
             'waiting' => $waiting,
             'queueStubs' => $modules->queueStubsFor($organization, $module),
-            'serviceQueuePanel' => $serviceQueuePanel,
+            'branchId' => $branchId,
+            'queueIntegration' => $branchId
+                ? $queueBridge->listMeta($organization, $module, $branchId)
+                : ['enabled' => false],
         ]);
     }
+
+    public function callNext(
+        Request $request,
+        string $module,
+        SpecialtyModuleService $modules,
+        CareQueueBridge $queueBridge,
+    ): RedirectResponse {
+        $definition = $modules->definition($module);
+        abort_unless($definition, 404);
+
+        $organization = $this->organization($request);
+        abort_unless($modules->isEnabled($organization, $module), 404);
+        abort_unless($queueBridge->isEnabled($organization), 404);
+
+        $member = $this->member($request);
+        $branchScope = app(OrganizationResolver::class)->branchScope($member);
+        $branchId = (int) ($request->input('branch_id') ?: $branchScope);
+        abort_unless($branchId > 0, 422);
+
+        $result = $queueBridge->callNext($organization, $module, $branchId);
+        $ticket = $result['ticket'] ?? null;
+        if (! $ticket) {
+            return back()->with('error', 'No patients waiting in this specialty queue.');
+        }
+
+        return back()->with('success', 'Called '.$ticket['ticket_number'].'.');
+    }
 }
diff --git a/app/Models/Appointment.php b/app/Models/Appointment.php
index e950025..c843e43 100644
--- a/app/Models/Appointment.php
+++ b/app/Models/Appointment.php
@@ -34,7 +34,8 @@ class Appointment extends Model
     protected $table = 'care_appointments';
 
     protected $fillable = [
-        'uuid', 'owner_ref', 'organization_id', 'branch_id', 'patient_id',
+        'uuid', 'queue_ticket_uuid', 'queue_ticket_number', 'queue_ticket_status',
+        'owner_ref', 'organization_id', 'branch_id', 'patient_id',
         'practitioner_id', 'department_id', 'visit_id', 'type', 'status',
         'scheduled_at', 'checked_in_at', 'waiting_at', 'started_at',
         'completed_at', 'cancelled_at', 'queue_position', 'reason', 'notes',
diff --git a/app/Models/Bill.php b/app/Models/Bill.php
index 3bbf161..fa530d6 100644
--- a/app/Models/Bill.php
+++ b/app/Models/Bill.php
@@ -26,7 +26,8 @@ class Bill extends Model
     protected $table = 'care_bills';
 
     protected $fillable = [
-        'uuid', 'owner_ref', 'organization_id', 'branch_id', 'visit_id', 'patient_id',
+        'uuid', 'queue_ticket_uuid', 'queue_ticket_number', 'queue_ticket_status',
+        'owner_ref', 'organization_id', 'branch_id', 'visit_id', 'patient_id',
         'invoice_number', 'status', 'subtotal_minor', 'discount_minor', 'tax_minor',
         'total_minor', 'amount_paid_minor', 'balance_minor', 'notes', 'created_by', 'finalized_at',
     ];
diff --git a/app/Models/InvestigationRequest.php b/app/Models/InvestigationRequest.php
index 96cda6f..540a581 100644
--- a/app/Models/InvestigationRequest.php
+++ b/app/Models/InvestigationRequest.php
@@ -30,7 +30,8 @@ class InvestigationRequest extends Model
     protected $table = 'care_investigation_requests';
 
     protected $fillable = [
-        'uuid', 'owner_ref', 'organization_id', 'branch_id', 'visit_id', 'consultation_id',
+        'uuid', 'queue_ticket_uuid', 'queue_ticket_number', 'queue_ticket_status',
+        'owner_ref', 'organization_id', 'branch_id', 'visit_id', 'consultation_id',
         'patient_id', 'investigation_type_id', 'practitioner_id', 'status', 'priority',
         'clinical_notes', 'requested_by', 'assigned_member_id', 'sample_barcode',
         'sample_collected_at', 'sample_collected_by', 'completed_at', 'delivered_at',
diff --git a/app/Models/Prescription.php b/app/Models/Prescription.php
index 04ef6e0..2c93a8e 100644
--- a/app/Models/Prescription.php
+++ b/app/Models/Prescription.php
@@ -24,7 +24,8 @@ class Prescription extends Model
     protected $table = 'care_prescriptions';
 
     protected $fillable = [
-        'uuid', 'owner_ref', 'organization_id', 'visit_id', 'consultation_id',
+        'uuid', 'queue_ticket_uuid', 'queue_ticket_number', 'queue_ticket_status',
+        'owner_ref', 'organization_id', 'visit_id', 'consultation_id',
         'patient_id', 'practitioner_id', 'status', 'notes',
         'prescribed_by', 'dispensed_by', 'dispensed_at',
     ];
diff --git a/app/Services/Care/AppointmentService.php b/app/Services/Care/AppointmentService.php
index 5daadc2..c400da7 100644
--- a/app/Services/Care/AppointmentService.php
+++ b/app/Services/Care/AppointmentService.php
@@ -19,6 +19,7 @@ class AppointmentService
     public function __construct(
         protected VisitService $visits,
         protected AppointmentPatientNotifier $notifier,
+        protected CareQueueBridge $queueBridge,
     ) {}
 
     public function queryForOrganization(string $ownerRef, int $organizationId): Builder
@@ -142,7 +143,10 @@ class AppointmentService
 
         AuditLogger::record($ownerRef, 'appointment.walk_in', $organization->id, $actorRef, Appointment::class, $appointment->id);
 
-        return $appointment->load(['patient', 'practitioner', 'branch', 'visit']);
+        $appointment = $appointment->load(['patient', 'practitioner', 'branch', 'visit']);
+        $this->queueBridge->issueForAppointment($organization, $appointment);
+
+        return $appointment->fresh(['patient', 'practitioner', 'branch', 'visit']);
     }
 
     public function checkIn(Appointment $appointment, string $ownerRef, ?string $actorRef = null): Appointment
@@ -167,6 +171,9 @@ class AppointmentService
 
         AuditLogger::record($ownerRef, 'appointment.checked_in', $appointment->organization_id, $actorRef, Appointment::class, $appointment->id);
 
+        $appointment = $appointment->fresh(['patient', 'practitioner', 'visit', 'organization']);
+        $this->queueBridge->issueForAppointment($appointment->organization, $appointment);
+
         return $appointment->fresh(['patient', 'practitioner', 'visit']);
     }
 
@@ -188,6 +195,11 @@ class AppointmentService
         $appointment->update($updates);
         AuditLogger::record($ownerRef, 'appointment.waiting', $appointment->organization_id, $actorRef, Appointment::class, $appointment->id);
 
+        $appointment = $appointment->fresh(['patient', 'practitioner', 'organization']);
+        if ($appointment->organization) {
+            $this->queueBridge->issueForAppointment($appointment->organization, $appointment);
+        }
+
         return $appointment->fresh(['patient', 'practitioner']);
     }
 
@@ -216,6 +228,11 @@ class AppointmentService
 
         AuditLogger::record($ownerRef, 'appointment.in_consultation', $appointment->organization_id, $actorRef, Appointment::class, $appointment->id);
 
+        $appointment = $appointment->fresh(['patient', 'practitioner', 'visit', 'organization']);
+        if ($appointment->organization) {
+            $this->queueBridge->serve($appointment->organization, $appointment);
+        }
+
         return $appointment->fresh(['patient', 'practitioner', 'visit']);
     }
 
@@ -234,6 +251,11 @@ class AppointmentService
 
         AuditLogger::record($ownerRef, 'appointment.completed', $appointment->organization_id, $actorRef, Appointment::class, $appointment->id);
 
+        $appointment = $appointment->fresh(['patient', 'practitioner', 'visit', 'organization']);
+        if ($appointment->organization) {
+            $this->queueBridge->complete($appointment->organization, $appointment);
+        }
+
         return $appointment->fresh(['patient', 'practitioner', 'visit']);
     }
 
diff --git a/app/Services/Care/BillService.php b/app/Services/Care/BillService.php
index 7eea235..bd5b0cd 100644
--- a/app/Services/Care/BillService.php
+++ b/app/Services/Care/BillService.php
@@ -22,6 +22,7 @@ class BillService
     public function __construct(
         protected InvoiceNumberGenerator $invoices,
         protected MerchantGatewayService $gateway,
+        protected CareQueueBridge $queueBridge,
     ) {}
 
     public function queryForOrganization(string $ownerRef, int $organizationId): Builder
@@ -81,6 +82,11 @@ class BillService
 
         AuditLogger::record($ownerRef, 'bill.created', $visit->organization_id, $actorRef, Bill::class, $bill->id);
 
+        $bill = $bill->fresh(['lineItems', 'patient', 'payments']);
+        if ($visit->organization) {
+            $this->queueBridge->issueForBill($visit->organization, $bill);
+        }
+
         return $bill->fresh(['lineItems', 'patient', 'payments']);
     }
 
@@ -441,6 +447,7 @@ class BillService
         $bill->refresh();
         $paid = $this->paidSum($bill);
         $balance = max(0, $bill->total_minor - $paid);
+        $wasPaid = $bill->status === Bill::STATUS_PAID;
 
         $status = Bill::STATUS_OPEN;
         if ($paid > 0 && $balance > 0) {
@@ -460,6 +467,13 @@ class BillService
             'balance_minor' => $balance,
             'status' => $status,
         ]);
+
+        if (! $wasPaid && $status === Bill::STATUS_PAID) {
+            $organization = Organization::query()->find($bill->organization_id);
+            if ($organization) {
+                $this->queueBridge->complete($organization, $bill);
+            }
+        }
     }
 
     protected function paidSum(Bill $bill): int
diff --git a/app/Services/Care/CarePermissions.php b/app/Services/Care/CarePermissions.php
index 4d1286d..bfd98b1 100644
--- a/app/Services/Care/CarePermissions.php
+++ b/app/Services/Care/CarePermissions.php
@@ -40,6 +40,7 @@ class CarePermissions
         ],
         'cashier' => [
             'dashboard.view', 'patients.view', 'bills.view', 'bills.manage', 'payments.manage',
+            'service_queues.console',
         ],
         'accountant' => [
             'dashboard.view', 'bills.view', 'reports.finance.view', 'reports.finance.export',
diff --git a/app/Services/Care/CareQueueBridge.php b/app/Services/Care/CareQueueBridge.php
new file mode 100644
index 0000000..ea6cf42
--- /dev/null
+++ b/app/Services/Care/CareQueueBridge.php
@@ -0,0 +1,386 @@
+<?php
+
+namespace App\Services\Care;
+
+use App\Models\Appointment;
+use App\Models\Bill;
+use App\Models\InvestigationRequest;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\Prescription;
+use App\Services\Queue\QueueClient;
+use Illuminate\Database\Eloquent\Model;
+use Illuminate\Http\Client\RequestException;
+use Illuminate\Support\Facades\Log;
+
+/**
+ * Bridges Care workflow entities to Ladill Queue tickets for the matching department queue.
+ */
+class CareQueueBridge
+{
+    public function __construct(
+        protected QueueClient $queue,
+        protected CareQueueProvisioner $provisioner,
+        protected PlanService $plans,
+        protected SpecialtyModuleService $specialties,
+    ) {}
+
+    public function isEnabled(Organization $organization): bool
+    {
+        return $this->plans->canUseQueueIntegration($organization)
+            && (bool) data_get($organization->settings, 'queue_integration_enabled')
+            && $this->queue->configured();
+    }
+
+    /**
+     * Resolve which queue context an appointment should use (specialty if applicable).
+     */
+    public function contextForAppointment(Organization $organization, Appointment $appointment): string
+    {
+        $departmentId = $appointment->department_id;
+        if (! $departmentId) {
+            return CareQueueContexts::CONSULTATION;
+        }
+
+        foreach ($this->specialties->enabledKeys($organization) as $key) {
+            $deptIds = data_get($organization->settings, "specialty_module_provisioning.{$key}.department_ids", []);
+            if (is_array($deptIds) && in_array($departmentId, array_map('intval', $deptIds), true)) {
+                return $key;
+            }
+        }
+
+        return CareQueueContexts::CONSULTATION;
+    }
+
+    public function issueForAppointment(Organization $organization, Appointment $appointment): ?Appointment
+    {
+        if (! $this->isEnabled($organization) || filled($appointment->queue_ticket_uuid)) {
+            return $appointment;
+        }
+
+        $context = $this->contextForAppointment($organization, $appointment);
+        $ticket = $this->issue(
+            $organization,
+            $context,
+            (int) $appointment->branch_id,
+            $appointment->patient,
+            [
+                'care_entity' => 'appointment',
+                'care_entity_uuid' => $appointment->uuid,
+                'care_entity_id' => $appointment->id,
+            ],
+            $appointment->type === Appointment::TYPE_WALK_IN ? 'walk_in' : 'appointment',
+            'appointment',
+        );
+
+        if (! $ticket) {
+            return $appointment;
+        }
+
+        $this->applyTicket($appointment, $ticket);
+
+        return $appointment->fresh();
+    }
+
+    public function issueForPrescription(Organization $organization, Prescription $prescription): ?Prescription
+    {
+        if (! $this->isEnabled($organization) || filled($prescription->queue_ticket_uuid)) {
+            return $prescription;
+        }
+
+        $prescription->loadMissing(['patient', 'visit']);
+        $branchId = (int) ($prescription->visit?->branch_id ?? 0);
+        if ($branchId < 1) {
+            return $prescription;
+        }
+
+        $ticket = $this->issue(
+            $organization,
+            CareQueueContexts::PHARMACY,
+            $branchId,
+            $prescription->patient,
+            [
+                'care_entity' => 'prescription',
+                'care_entity_uuid' => $prescription->uuid,
+                'care_entity_id' => $prescription->id,
+            ],
+        );
+
+        if (! $ticket) {
+            return $prescription;
+        }
+
+        $this->applyTicket($prescription, $ticket);
+
+        return $prescription->fresh();
+    }
+
+    public function issueForInvestigation(Organization $organization, InvestigationRequest $request): ?InvestigationRequest
+    {
+        if (! $this->isEnabled($organization) || filled($request->queue_ticket_uuid)) {
+            return $request;
+        }
+
+        $request->loadMissing('patient');
+        $ticket = $this->issue(
+            $organization,
+            CareQueueContexts::LABORATORY,
+            (int) $request->branch_id,
+            $request->patient,
+            [
+                'care_entity' => 'investigation_request',
+                'care_entity_uuid' => $request->uuid,
+                'care_entity_id' => $request->id,
+            ],
+        );
+
+        if (! $ticket) {
+            return $request;
+        }
+
+        $this->applyTicket($request, $ticket);
+
+        return $request->fresh();
+    }
+
+    public function issueForBill(Organization $organization, Bill $bill): ?Bill
+    {
+        if (! $this->isEnabled($organization) || filled($bill->queue_ticket_uuid)) {
+            return $bill;
+        }
+
+        if (in_array($bill->status, [Bill::STATUS_PAID, Bill::STATUS_VOID], true)) {
+            return $bill;
+        }
+
+        $bill->loadMissing('patient');
+        $ticket = $this->issue(
+            $organization,
+            CareQueueContexts::BILLING,
+            (int) $bill->branch_id,
+            $bill->patient,
+            [
+                'care_entity' => 'bill',
+                'care_entity_uuid' => $bill->uuid,
+                'care_entity_id' => $bill->id,
+            ],
+        );
+
+        if (! $ticket) {
+            return $bill;
+        }
+
+        $this->applyTicket($bill, $ticket);
+
+        return $bill->fresh();
+    }
+
+    /**
+     * Call the next waiting ticket for a Care page context + branch.
+     *
+     * @return array{ticket: ?array<string, mixed>, entity: ?Model, resources: ?array<string, mixed>}
+     */
+    public function callNext(Organization $organization, string $context, int $branchId): array
+    {
+        $resources = $this->provisioner->ensure($organization, $context, $branchId);
+        if (! $resources || empty($resources['queue_uuid']) || empty($resources['counter_uuid'])) {
+            return ['ticket' => null, 'entity' => null, 'resources' => $resources];
+        }
+
+        $owner = (string) $organization->owner_ref;
+
+        try {
+            $ticket = $this->queue->callNext(
+                $owner,
+                (string) $resources['queue_uuid'],
+                (string) $resources['counter_uuid'],
+            );
+        } catch (RequestException $e) {
+            Log::warning('care.queue_call_next_failed', [
+                'context' => $context,
+                'branch_id' => $branchId,
+                'message' => $e->getMessage(),
+            ]);
+
+            return ['ticket' => null, 'entity' => null, 'resources' => $resources];
+        }
+
+        if (! $ticket) {
+            return ['ticket' => null, 'entity' => null, 'resources' => $resources];
+        }
+
+        $entity = $this->findEntityByTicket($organization, $context, (string) ($ticket['uuid'] ?? ''));
+        if ($entity) {
+            $this->applyTicket($entity, $ticket);
+        }
+
+        return ['ticket' => $ticket, 'entity' => $entity?->fresh(), 'resources' => $resources];
+    }
+
+    /**
+     * Mark ticket as serving (Queue "start").
+     *
+     * @return array<string, mixed>|null
+     */
+    public function serve(Organization $organization, Model $entity): ?array
+    {
+        return $this->ticketAction($organization, $entity, 'start');
+    }
+
+    /**
+     * Complete the Queue ticket linked to a Care entity.
+     *
+     * @return array<string, mixed>|null
+     */
+    public function complete(Organization $organization, Model $entity): ?array
+    {
+        return $this->ticketAction($organization, $entity, 'complete');
+    }
+
+    /**
+     * Recall the Queue ticket linked to a Care entity.
+     *
+     * @return array<string, mixed>|null
+     */
+    public function recall(Organization $organization, Model $entity): ?array
+    {
+        return $this->ticketAction($organization, $entity, 'recall');
+    }
+
+    /**
+     * @return array{enabled: bool, context: string, queue_uuid: ?string, counter_uuid: ?string}
+     */
+    public function listMeta(Organization $organization, string $context, int $branchId): array
+    {
+        if (! $this->isEnabled($organization)) {
+            return [
+                'enabled' => false,
+                'context' => $context,
+                'queue_uuid' => null,
+                'counter_uuid' => null,
+            ];
+        }
+
+        $resources = $this->provisioner->ensure($organization->fresh(), $context, $branchId);
+
+        return [
+            'enabled' => true,
+            'context' => $context,
+            'queue_uuid' => $resources['queue_uuid'] ?? null,
+            'counter_uuid' => $resources['counter_uuid'] ?? null,
+        ];
+    }
+
+    /**
+     * @param  array<string, mixed>  $metadata
+     * @return array<string, mixed>|null
+     */
+    protected function issue(
+        Organization $organization,
+        string $context,
+        int $branchId,
+        ?Patient $patient,
+        array $metadata = [],
+        string $priority = 'walk_in',
+        string $source = 'api',
+    ): ?array {
+        $resources = $this->provisioner->ensure($organization, $context, $branchId);
+        if (! $resources || empty($resources['queue_uuid'])) {
+            Log::info('care.queue_issue_skipped_no_queue', [
+                'context' => $context,
+                'branch_id' => $branchId,
+            ]);
+
+            return null;
+        }
+
+        $owner = (string) $organization->owner_ref;
+
+        try {
+            return $this->queue->issueTicket($owner, [
+                'service_queue_id' => $resources['queue_uuid'],
+                'customer_name' => $patient?->fullName(),
+                'customer_phone' => $patient?->phone,
+                'priority' => $priority,
+                'source' => $source,
+                'metadata' => $metadata,
+            ]);
+        } catch (\Throwable $e) {
+            Log::warning('care.queue_issue_failed', [
+                'context' => $context,
+                'branch_id' => $branchId,
+                'message' => $e->getMessage(),
+            ]);
+
+            return null;
+        }
+    }
+
+    /**
+     * @param  array<string, mixed>  $ticket
+     */
+    protected function applyTicket(Model $entity, array $ticket): void
+    {
+        $entity->forceFill([
+            'queue_ticket_uuid' => $ticket['uuid'] ?? $entity->getAttribute('queue_ticket_uuid'),
+            'queue_ticket_number' => $ticket['ticket_number'] ?? $entity->getAttribute('queue_ticket_number'),
+            'queue_ticket_status' => $ticket['status'] ?? $entity->getAttribute('queue_ticket_status'),
+        ])->save();
+    }
+
+    /**
+     * @return array<string, mixed>|null
+     */
+    protected function ticketAction(Organization $organization, Model $entity, string $action): ?array
+    {
+        $uuid = (string) $entity->getAttribute('queue_ticket_uuid');
+        if ($uuid === '' || ! $this->isEnabled($organization)) {
+            return null;
+        }
+
+        try {
+            $ticket = $this->queue->ticketAction((string) $organization->owner_ref, $uuid, [
+                'action' => $action,
+            ]);
+            $this->applyTicket($entity, $ticket);
+
+            return $ticket;
+        } catch (\Throwable $e) {
+            Log::warning('care.queue_ticket_action_failed', [
+                'action' => $action,
+                'ticket_uuid' => $uuid,
+                'message' => $e->getMessage(),
+            ]);
+
+            return null;
+        }
+    }
+
+    protected function findEntityByTicket(Organization $organization, string $context, string $ticketUuid): ?Model
+    {
+        if ($ticketUuid === '') {
+            return null;
+        }
+
+        $owner = (string) $organization->owner_ref;
+
+        return match (true) {
+            $context === CareQueueContexts::PHARMACY => Prescription::owned($owner)
+                ->where('organization_id', $organization->id)
+                ->where('queue_ticket_uuid', $ticketUuid)
+                ->first(),
+            $context === CareQueueContexts::LABORATORY => InvestigationRequest::owned($owner)
+                ->where('organization_id', $organization->id)
+                ->where('queue_ticket_uuid', $ticketUuid)
+                ->first(),
+            $context === CareQueueContexts::BILLING => Bill::owned($owner)
+                ->where('organization_id', $organization->id)
+                ->where('queue_ticket_uuid', $ticketUuid)
+                ->first(),
+            default => Appointment::owned($owner)
+                ->where('organization_id', $organization->id)
+                ->where('queue_ticket_uuid', $ticketUuid)
+                ->first(),
+        };
+    }
+}
diff --git a/app/Services/Care/CareQueueContexts.php b/app/Services/Care/CareQueueContexts.php
new file mode 100644
index 0000000..23ec53a
--- /dev/null
+++ b/app/Services/Care/CareQueueContexts.php
@@ -0,0 +1,63 @@
+<?php
+
+namespace App\Services\Care;
+
+/**
+ * Canonical Care → Ladill Queue department / specialty contexts.
+ */
+class CareQueueContexts
+{
+    public const RECEPTION = 'reception';
+
+    public const CONSULTATION = 'consultation';
+
+    public const PHARMACY = 'pharmacy';
+
+    public const LABORATORY = 'laboratory';
+
+    public const BILLING = 'billing';
+
+    /**
+     * Core department queues provisioned for every branch when Queue integration is on.
+     *
+     * @return array<string, array{name: string, prefix: string}>
+     */
+    public static function departments(): array
+    {
+        return [
+            self::RECEPTION => ['name' => 'Reception', 'prefix' => 'R'],
+            self::CONSULTATION => ['name' => 'Consultation', 'prefix' => 'C'],
+            self::PHARMACY => ['name' => 'Pharmacy', 'prefix' => 'P'],
+            self::LABORATORY => ['name' => 'Laboratory', 'prefix' => 'L'],
+            self::BILLING => ['name' => 'Billing', 'prefix' => 'B'],
+        ];
+    }
+
+    public static function isDepartment(string $context): bool
+    {
+        return array_key_exists($context, self::departments());
+    }
+
+    public static function isSpecialty(string $context): bool
+    {
+        return array_key_exists($context, config('care.specialty_modules', []));
+    }
+
+    public static function queueExternalKey(string $context, int|string $careBranchId): string
+    {
+        if (self::isSpecialty($context)) {
+            return "care:specialty:{$context}:queue:{$careBranchId}";
+        }
+
+        return "care:dept:{$context}:queue:{$careBranchId}";
+    }
+
+    public static function counterExternalKey(string $context, int|string $careBranchId): string
+    {
+        if (self::isSpecialty($context)) {
+            return "care:specialty:{$context}:counter:{$careBranchId}";
+        }
+
+        return "care:dept:{$context}:counter:{$careBranchId}";
+    }
+}
diff --git a/app/Services/Care/CareQueueProvisioner.php b/app/Services/Care/CareQueueProvisioner.php
new file mode 100644
index 0000000..a935f98
--- /dev/null
+++ b/app/Services/Care/CareQueueProvisioner.php
@@ -0,0 +1,163 @@
+<?php
+
+namespace App\Services\Care;
+
+use App\Models\Branch;
+use App\Models\Organization;
+use App\Services\Queue\QueueClient;
+use Illuminate\Support\Facades\Log;
+
+/**
+ * Idempotently provisions Ladill Queue queues/counters for Care departments per branch.
+ */
+class CareQueueProvisioner
+{
+    public function __construct(
+        protected QueueClient $queue,
+        protected PlanService $plans,
+    ) {}
+
+    public function shouldProvision(Organization $organization): bool
+    {
+        return $this->plans->canUseQueueIntegration($organization)
+            && (bool) data_get($organization->settings, 'queue_integration_enabled')
+            && $this->queue->configured();
+    }
+
+    /**
+     * Provision core department queues for all org branches. Returns updated settings fragment.
+     *
+     * @return array<string, mixed>
+     */
+    public function provisionOrganization(Organization $organization): array
+    {
+        if (! $this->shouldProvision($organization)) {
+            return (array) data_get($organization->settings, 'department_queue_provisioning', []);
+        }
+
+        $owner = (string) $organization->owner_ref;
+        $branches = Branch::owned($owner)
+            ->where('organization_id', $organization->id)
+            ->where('is_active', true)
+            ->orderBy('name')
+            ->get();
+
+        $provisioning = (array) data_get($organization->settings, 'department_queue_provisioning', []);
+
+        foreach (CareQueueContexts::departments() as $context => $meta) {
+            $queues = is_array($provisioning[$context]['queues'] ?? null)
+                ? $provisioning[$context]['queues']
+                : [];
+            $byBranch = collect($queues)->keyBy(fn ($q) => (string) ($q['branch_id'] ?? ''));
+
+            foreach ($branches as $branch) {
+                $prior = $byBranch->get((string) $branch->id, []);
+                $stub = [
+                    'name' => $meta['name'],
+                    'prefix' => $meta['prefix'],
+                    'module' => $context,
+                    'branch_id' => $branch->id,
+                    'branch_name' => $branch->name,
+                    'active' => true,
+                    'queue_external_key' => CareQueueContexts::queueExternalKey($context, $branch->id),
+                    'counter_external_key' => CareQueueContexts::counterExternalKey($context, $branch->id),
+                    'queue_uuid' => $prior['queue_uuid'] ?? null,
+                    'counter_uuid' => $prior['counter_uuid'] ?? null,
+                    'synced' => false,
+                ];
+
+                try {
+                    $synced = $this->queue->syncSpecialtyQueueStubs($owner, [$stub]);
+                    $stub = $synced[0] ?? $stub;
+                } catch (\Throwable $e) {
+                    Log::warning('care.queue_department_provision_failed', [
+                        'context' => $context,
+                        'branch_id' => $branch->id,
+                        'message' => $e->getMessage(),
+                    ]);
+                }
+
+                $byBranch->put((string) $branch->id, $stub);
+            }
+
+            $provisioning[$context] = [
+                'queues' => $byBranch->values()->all(),
+            ];
+        }
+
+        $settings = $organization->settings ?? [];
+        $settings['department_queue_provisioning'] = $provisioning;
+        $organization->update(['settings' => $settings]);
+
+        return $provisioning;
+    }
+
+    /**
+     * @return array{queue_uuid: ?string, counter_uuid: ?string, queue_external_key: string, counter_external_key: string, synced: bool}|null
+     */
+    public function resourcesFor(
+        Organization $organization,
+        string $context,
+        int $branchId,
+    ): ?array {
+        if (CareQueueContexts::isSpecialty($context)) {
+            $queues = data_get($organization->settings, "specialty_module_provisioning.{$context}.queues", []);
+        } else {
+            $queues = data_get($organization->settings, "department_queue_provisioning.{$context}.queues", []);
+        }
+
+        if (! is_array($queues)) {
+            return null;
+        }
+
+        $match = collect($queues)->first(
+            fn ($q) => (int) ($q['branch_id'] ?? 0) === $branchId && ($q['active'] ?? true)
+        );
+
+        if (! $match) {
+            return null;
+        }
+
+        return [
+            'queue_uuid' => $match['queue_uuid'] ?? null,
+            'counter_uuid' => $match['counter_uuid'] ?? null,
+            'queue_external_key' => (string) ($match['queue_external_key']
+                ?? CareQueueContexts::queueExternalKey($context, $branchId)),
+            'counter_external_key' => (string) ($match['counter_external_key']
+                ?? CareQueueContexts::counterExternalKey($context, $branchId)),
+            'synced' => (bool) ($match['synced'] ?? false),
+        ];
+    }
+
+    /**
+     * Ensure resources exist for one context+branch (lazy provision).
+     *
+     * @return array{queue_uuid: ?string, counter_uuid: ?string, queue_external_key: string, counter_external_key: string, synced: bool}|null
+     */
+    public function ensure(
+        Organization $organization,
+        string $context,
+        int $branchId,
+    ): ?array {
+        $existing = $this->resourcesFor($organization, $context, $branchId);
+        if ($existing && ! empty($existing['queue_uuid']) && ! empty($existing['counter_uuid'])) {
+            return $existing;
+        }
+
+        if (! $this->shouldProvision($organization)) {
+            return $existing;
+        }
+
+        if (CareQueueContexts::isSpecialty($context)) {
+            return $existing;
+        }
+
+        if (! CareQueueContexts::isDepartment($context)) {
+            return null;
+        }
+
+        $this->provisionOrganization($organization->fresh());
+
+        return $this->resourcesFor($organization->fresh(), $context, $branchId);
+    }
+}
diff --git a/app/Services/Care/DemoTenantSeeder.php b/app/Services/Care/DemoTenantSeeder.php
index 6608535..522fff6 100644
--- a/app/Services/Care/DemoTenantSeeder.php
+++ b/app/Services/Care/DemoTenantSeeder.php
@@ -462,6 +462,14 @@ class DemoTenantSeeder
         } catch (\Throwable) {
             // Demo seed should not fail if Queue API is unreachable; settings flag remains.
         }
+
+        if (data_get($organization->fresh()->settings, 'queue_integration_enabled')) {
+            try {
+                app(CareQueueProvisioner::class)->provisionOrganization($organization->fresh());
+            } catch (\Throwable) {
+                // Best-effort department queue stubs for Pro demo ticket flow.
+            }
+        }
     }
 
     /**
diff --git a/app/Services/Care/InvestigationService.php b/app/Services/Care/InvestigationService.php
index 1f1eb2e..43b92ae 100644
--- a/app/Services/Care/InvestigationService.php
+++ b/app/Services/Care/InvestigationService.php
@@ -18,6 +18,10 @@ use InvalidArgumentException;
 
 class InvestigationService
 {
+    public function __construct(
+        protected CareQueueBridge $queueBridge,
+    ) {}
+
     public function queryForOrganization(string $ownerRef, int $organizationId): Builder
     {
         return InvestigationRequest::owned($ownerRef)->where('organization_id', $organizationId);
@@ -108,7 +112,13 @@ class InvestigationService
                 $request->id,
             );
 
-            $created->push($request->load('investigationType'));
+            $request = $request->load(['investigationType', 'patient']);
+            $organization = Organization::query()->find($request->organization_id);
+            if ($organization) {
+                $this->queueBridge->issueForInvestigation($organization, $request);
+            }
+
+            $created->push($request->fresh(['investigationType', 'patient']));
         }
 
         return $created;
@@ -131,7 +141,13 @@ class InvestigationService
 
         AuditLogger::record($ownerRef, 'investigation.sample_collected', $request->organization_id, $actorRef, InvestigationRequest::class, $request->id);
 
-        return $request->fresh(['patient', 'investigationType']);
+        $request = $request->fresh(['patient', 'investigationType']);
+        $organization = Organization::query()->find($request->organization_id);
+        if ($organization) {
+            $this->queueBridge->serve($organization, $request);
+        }
+
+        return $request;
     }
 
     public function startProcessing(
@@ -261,7 +277,13 @@ class InvestigationService
 
         AuditLogger::record($ownerRef, 'investigation.approved', $request->organization_id, $actorRef, InvestigationRequest::class, $request->id);
 
-        return $request->fresh(['patient', 'investigationType', 'result.values']);
+        $request = $request->fresh(['patient', 'investigationType', 'result.values']);
+        $organization = Organization::query()->find($request->organization_id);
+        if ($organization) {
+            $this->queueBridge->complete($organization, $request);
+        }
+
+        return $request;
     }
 
     public function deliver(InvestigationRequest $request, string $ownerRef, ?string $actorRef = null): InvestigationRequest
diff --git a/app/Services/Care/PharmacyService.php b/app/Services/Care/PharmacyService.php
index 40a0674..2b04cc1 100644
--- a/app/Services/Care/PharmacyService.php
+++ b/app/Services/Care/PharmacyService.php
@@ -15,6 +15,10 @@ use InvalidArgumentException;
 
 class PharmacyService
 {
+    public function __construct(
+        protected CareQueueBridge $queueBridge,
+    ) {}
+
     public function queryDrugs(string $ownerRef, int $organizationId): Builder
     {
         return Drug::owned($ownerRef)->where('organization_id', $organizationId);
@@ -197,6 +201,12 @@ class PharmacyService
 
         AuditLogger::record($ownerRef, 'prescription.dispensed', $prescription->organization_id, $actorRef, Prescription::class, $prescription->id);
 
-        return $prescription->fresh(['items', 'patient']);
+        $prescription = $prescription->fresh(['items', 'patient']);
+        $organization = Organization::query()->find($prescription->organization_id);
+        if ($organization) {
+            $this->queueBridge->complete($organization, $prescription);
+        }
+
+        return $prescription;
     }
 }
diff --git a/app/Services/Care/PrescriptionService.php b/app/Services/Care/PrescriptionService.php
index 3cfaa26..6d7eba2 100644
--- a/app/Services/Care/PrescriptionService.php
+++ b/app/Services/Care/PrescriptionService.php
@@ -3,6 +3,7 @@
 namespace App\Services\Care;
 
 use App\Models\Consultation;
+use App\Models\Organization;
 use App\Models\Prescription;
 use App\Models\PrescriptionItem;
 use Illuminate\Contracts\Pagination\LengthAwarePaginator;
@@ -12,6 +13,10 @@ use InvalidArgumentException;
 
 class PrescriptionService
 {
+    public function __construct(
+        protected CareQueueBridge $queueBridge,
+    ) {}
+
     public function queryForOrganization(string $ownerRef, int $organizationId): Builder
     {
         return Prescription::owned($ownerRef)->where('organization_id', $organizationId);
@@ -89,6 +94,14 @@ class PrescriptionService
             $prescription->id,
         );
 
+        $prescription = $prescription->fresh(['items', 'patient', 'practitioner', 'visit']);
+        if ($status === Prescription::STATUS_ACTIVE) {
+            $organization = Organization::query()->find($prescription->organization_id);
+            if ($organization) {
+                $this->queueBridge->issueForPrescription($organization, $prescription);
+            }
+        }
+
         return $prescription->fresh(['items', 'patient', 'practitioner']);
     }
 
@@ -122,6 +135,12 @@ class PrescriptionService
         $prescription->update(['status' => Prescription::STATUS_ACTIVE]);
         AuditLogger::record($ownerRef, 'prescription.activated', $prescription->organization_id, $actorRef, Prescription::class, $prescription->id);
 
+        $prescription = $prescription->fresh(['items', 'patient', 'visit']);
+        $organization = Organization::query()->find($prescription->organization_id);
+        if ($organization) {
+            $this->queueBridge->issueForPrescription($organization, $prescription);
+        }
+
         return $prescription->fresh(['items', 'patient']);
     }
 
@@ -137,6 +156,12 @@ class PrescriptionService
 
         AuditLogger::record($ownerRef, 'prescription.dispensed', $prescription->organization_id, $actorRef, Prescription::class, $prescription->id);
 
+        $prescription = $prescription->fresh(['items', 'patient', 'visit']);
+        $organization = Organization::query()->find($prescription->organization_id);
+        if ($organization) {
+            $this->queueBridge->complete($organization, $prescription);
+        }
+
         return $prescription->fresh(['items', 'patient']);
     }
 
diff --git a/app/Services/Queue/QueueClient.php b/app/Services/Queue/QueueClient.php
index 296b92c..ae0f695 100644
--- a/app/Services/Queue/QueueClient.php
+++ b/app/Services/Queue/QueueClient.php
@@ -197,6 +197,45 @@ class QueueClient
         return (array) ($response->json('data') ?? []);
     }
 
+    /**
+     * @param  array<string, mixed>  $payload
+     * @return array<string, mixed>
+     */
+    public function issueTicket(string $owner, array $payload): array
+    {
+        $response = $this->http($owner)->post($this->base().'/tickets', $payload);
+        $response->throw();
+
+        return (array) ($response->json('data') ?? []);
+    }
+
+    /**
+     * @return array<string, mixed>|null
+     */
+    public function callNext(string $owner, string $queueUuid, string $counterUuid): ?array
+    {
+        $response = $this->http($owner)->post($this->base().'/queues/'.$queueUuid.'/call-next', [
+            'counter_id' => $counterUuid,
+        ]);
+        $response->throw();
+
+        $data = $response->json('data');
+
+        return is_array($data) ? $data : null;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     * @return array<string, mixed>
+     */
+    public function ticketAction(string $owner, string $ticketUuid, array $payload): array
+    {
+        $response = $this->http($owner)->post($this->base().'/tickets/'.$ticketUuid.'/action', $payload);
+        $response->throw();
+
+        return (array) ($response->json('data') ?? []);
+    }
+
     /**
      * Create or link real Queue queues/counters for Care specialty stubs.
      * Idempotent via external_key (and Queue-side name+branch fallback).
diff --git a/database/migrations/2026_07_17_160000_add_queue_ticket_fields_to_care_entities.php b/database/migrations/2026_07_17_160000_add_queue_ticket_fields_to_care_entities.php
new file mode 100644
index 0000000..48dca57
--- /dev/null
+++ b/database/migrations/2026_07_17_160000_add_queue_ticket_fields_to_care_entities.php
@@ -0,0 +1,30 @@
+<?php
+
+use Illuminate\Database\Migrations\Migration;
+use Illuminate\Database\Schema\Blueprint;
+use Illuminate\Support\Facades\Schema;
+
+return new class extends Migration
+{
+    public function up(): void
+    {
+        foreach (['care_appointments', 'care_prescriptions', 'care_investigation_requests', 'care_bills'] as $table) {
+            Schema::table($table, function (Blueprint $blueprint) {
+                $blueprint->string('queue_ticket_uuid', 36)->nullable()->after('uuid');
+                $blueprint->string('queue_ticket_number', 32)->nullable()->after('queue_ticket_uuid');
+                $blueprint->string('queue_ticket_status', 32)->nullable()->after('queue_ticket_number');
+                $blueprint->index('queue_ticket_uuid');
+            });
+        }
+    }
+
+    public function down(): void
+    {
+        foreach (['care_appointments', 'care_prescriptions', 'care_investigation_requests', 'care_bills'] as $table) {
+            Schema::table($table, function (Blueprint $blueprint) {
+                $blueprint->dropIndex(['queue_ticket_uuid']);
+                $blueprint->dropColumn(['queue_ticket_uuid', 'queue_ticket_number', 'queue_ticket_status']);
+            });
+        }
+    }
+};
diff --git a/resources/views/care/appointments/index.blade.php b/resources/views/care/appointments/index.blade.php
index 37c29c7..36b100e 100644
--- a/resources/views/care/appointments/index.blade.php
+++ b/resources/views/care/appointments/index.blade.php
@@ -85,7 +85,5 @@
         </div>
 
         <div>{{ $appointments->links() }}</div>
-
-        @include('care.service-queues._panel')
     </div>
 </x-app-layout>
diff --git a/resources/views/care/bills/index.blade.php b/resources/views/care/bills/index.blade.php
index 1155f4e..bf401df 100644
--- a/resources/views/care/bills/index.blade.php
+++ b/resources/views/care/bills/index.blade.php
@@ -15,23 +15,61 @@
         </select>
         <button type="submit" class="btn-primary">Filter</button>
     </form>
+
+    <div class="mt-4">
+        @include('care.partials.queue-ops', [
+            'queueIntegration' => $queueIntegration ?? null,
+            'queueCallNextRoute' => 'care.bills.call-next',
+            'queueCallNextParams' => [],
+            'branchId' => $branchId ?? null,
+        ])
+    </div>
+
     <div class="mt-4 overflow-hidden rounded-2xl border border-slate-200 bg-white">
         <table class="min-w-full text-sm">
             <thead class="bg-slate-50 text-left text-xs uppercase text-slate-500">
-                <tr><th class="px-4 py-3">Invoice</th><th class="px-4 py-3">Patient</th><th class="px-4 py-3">Total</th><th class="px-4 py-3">Balance</th><th class="px-4 py-3">Status</th><th></th></tr>
+                <tr>
+                    <th class="px-4 py-3">Ticket</th>
+                    <th class="px-4 py-3">Invoice</th>
+                    <th class="px-4 py-3">Patient</th>
+                    <th class="px-4 py-3">Total</th>
+                    <th class="px-4 py-3">Balance</th>
+                    <th class="px-4 py-3">Status</th>
+                    <th></th>
+                </tr>
             </thead>
             <tbody class="divide-y divide-slate-50">
                 @forelse ($bills as $bill)
                     <tr>
+                        <td class="px-4 py-3">
+                            @if (! empty($queueIntegration['enabled']) && $bill->queue_ticket_number)
+                                @include('care.partials.queue-ticket', [
+                                    'ticketNumber' => $bill->queue_ticket_number,
+                                    'ticketStatus' => $bill->queue_ticket_status,
+                                ])
+                            @else
+                                <span class="text-slate-400">—</span>
+                            @endif
+                        </td>
                         <td class="px-4 py-3 font-mono text-xs">{{ $bill->invoice_number }}</td>
                         <td class="px-4 py-3">{{ $bill->patient->fullName() }}</td>
                         <td class="px-4 py-3">{{ $money($bill->total_minor) }}</td>
                         <td class="px-4 py-3 {{ $bill->balance_minor > 0 ? 'text-amber-700' : '' }}">{{ $money($bill->balance_minor) }}</td>
                         <td class="px-4 py-3">{{ $statuses[$bill->status] ?? $bill->status }}</td>
-                        <td class="px-4 py-3 text-right"><a href="{{ route('care.bills.show', $bill) }}" class="text-sky-600">View</a></td>
+                        <td class="px-4 py-3 text-right">
+                            <div class="flex items-center justify-end gap-2">
+                                @if (! empty($queueIntegration['enabled']) && $bill->queue_ticket_uuid && ($bill->queue_ticket_status ?? '') !== 'serving' && $bill->balance_minor > 0)
+                                    <form method="POST" action="{{ route('care.bills.serve', $bill) }}">
+                                        @csrf
+                                        <button type="submit" class="rounded-lg bg-sky-600 px-2.5 py-1 text-xs font-medium text-white hover:bg-sky-700">Serve</button>
+                                    </form>
+                                @endif
+                                <a href="{{ route('care.bills.show', $bill) }}" class="text-sky-600">View</a>
+                            </div>
+                        </td>
                     </tr>
                 @empty
-                    <tr><td colspan="6" class="px-4 py-8 text-center text-slate-500">No bills yet.</td></tr>
+                    <tr><td colspan="7" class="px-4 py-8 text-center text-slate-500">No bills yet.</td></tr>
                 @endforelse
             </tbody>
         </table>
diff --git a/resources/views/care/dashboard.blade.php b/resources/views/care/dashboard.blade.php
index 0f8ba08..33c7d92 100644
--- a/resources/views/care/dashboard.blade.php
+++ b/resources/views/care/dashboard.blade.php
@@ -192,12 +192,6 @@
         </section>
     @endif
 
-    @if (! empty($serviceQueuePanel['enabled']))
-        <div class="mt-6">
-            @include('care.service-queues._panel')
-        </div>
-    @endif
-
     @if (! empty($specialtyModules))
         <section class="mt-6">
             <h2 class="text-sm font-semibold text-slate-900">Specialty modules</h2>
diff --git a/resources/views/care/lab/queue/index.blade.php b/resources/views/care/lab/queue/index.blade.php
index fb917f9..2b69081 100644
--- a/resources/views/care/lab/queue/index.blade.php
+++ b/resources/views/care/lab/queue/index.blade.php
@@ -29,21 +29,42 @@
         <button type="submit" class="btn-primary">Filter</button>
     </form>
 
+    <div class="mt-4">
+        @include('care.partials.queue-ops', [
+            'queueIntegration' => $queueIntegration ?? null,
+            'queueCallNextRoute' => 'care.lab.queue.call-next',
+            'queueCallNextParams' => [],
+            'branchId' => $branchId,
+        ])
+    </div>
+
     <div class="mt-4 space-y-3">
         @forelse ($queue as $item)
             <div class="flex items-center justify-between rounded-2xl border border-slate-200 bg-white p-4">
                 <div>
-                    <p class="font-medium text-slate-900">{{ $item->patient->fullName() }} — {{ $item->investigationType->name }}</p>
+                    <p class="font-medium text-slate-900">
+                        @if (! empty($queueIntegration['enabled']) && $item->queue_ticket_number)
+                            @include('care.partials.queue-ticket', [
+                                'ticketNumber' => $item->queue_ticket_number,
+                                'ticketStatus' => $item->queue_ticket_status,
+                            ])
+                        @endif
+                        {{ $item->patient->fullName() }} — {{ $item->investigationType->name }}
+                    </p>
                     <p class="text-xs text-slate-500">{{ $statuses[$item->status] ?? $item->status }} · {{ $item->priority }} · {{ $item->created_at->diffForHumans() }}</p>
                 </div>
-                <a href="{{ route('care.lab.requests.show', $item) }}" class="text-sm text-sky-600">Open</a>
+                <div class="flex items-center gap-2">
+                    @if (! empty($queueIntegration['enabled']) && $item->queue_ticket_uuid && ($item->queue_ticket_status ?? '') !== 'serving')
+                        <form method="POST" action="{{ route('care.lab.queue.serve', $item) }}">
+                            @csrf
+                            <button type="submit" class="rounded-lg bg-sky-600 px-3 py-1.5 text-xs font-medium text-white hover:bg-sky-700">Serve</button>
+                        </form>
+                    @endif
+                    <a href="{{ route('care.lab.requests.show', $item) }}" class="text-sm text-sky-600">Open</a>
+                </div>
             </div>
         @empty
             <p class="rounded-2xl border border-dashed border-slate-200 bg-white p-8 text-center text-sm text-slate-500">Queue is empty.</p>
         @endforelse
     </div>
-
-    <div class="mt-6">
-        @include('care.service-queues._panel')
-    </div>
 </x-app-layout>
diff --git a/resources/views/care/partials/queue-ops.blade.php b/resources/views/care/partials/queue-ops.blade.php
new file mode 100644
index 0000000..c6be681
--- /dev/null
+++ b/resources/views/care/partials/queue-ops.blade.php
@@ -0,0 +1,26 @@
+{{-- Inline Queue ops when Care↔Queue integration is enabled (not a bolted-on Service counter). --}}
+@php
+  $qi = $queueIntegration ?? null;
+  $callNextRoute = $queueCallNextRoute ?? null;
+  $callNextParams = $queueCallNextParams ?? [];
+@endphp
+@if (! empty($qi['enabled']) && $callNextRoute)
+  <div class="flex flex-wrap items-center justify-between gap-3 rounded-xl border border-sky-100 bg-sky-50/70 px-4 py-3">
+    <div>
+      <p class="text-xs font-semibold uppercase tracking-wide text-sky-700">Queue</p>
+      <p class="text-sm text-slate-600">Call next, serve, and complete on this list — tickets are for this department only.</p>
+    </div>
+    <form method="POST" action="{{ route($callNextRoute, $callNextParams) }}">
+      @csrf
+      @foreach ($callNextParams as $key => $value)
+        @if (is_scalar($value))
+          <input type="hidden" name="{{ $key }}" value="{{ $value }}">
+        @endif
+      @endforeach
+      @if (! empty($branchId))
+        <input type="hidden" name="branch_id" value="{{ $branchId }}">
+      @endif
+      <button type="submit" class="btn-primary text-sm">Call next</button>
+    </form>
+  </div>
+@endif
diff --git a/resources/views/care/partials/queue-ticket.blade.php b/resources/views/care/partials/queue-ticket.blade.php
new file mode 100644
index 0000000..59ba6db
--- /dev/null
+++ b/resources/views/care/partials/queue-ticket.blade.php
@@ -0,0 +1,18 @@
+@php
+  $status = $ticketStatus ?? null;
+  $number = $ticketNumber ?? null;
+@endphp
+@if ($number)
+  <span class="mr-2 inline-flex items-center gap-1.5">
+    <span class="inline-flex h-7 min-w-[2.5rem] items-center justify-center rounded-md bg-sky-100 px-1.5 font-mono text-xs font-bold text-sky-800">{{ $number }}</span>
+    @if ($status)
+      <span @class([
+        'rounded-full px-2 py-0.5 text-[10px] font-semibold uppercase tracking-wide',
+        'bg-amber-100 text-amber-800' => $status === 'waiting',
+        'bg-indigo-100 text-indigo-800' => $status === 'called',
+        'bg-emerald-100 text-emerald-800' => $status === 'serving',
+        'bg-slate-100 text-slate-600' => ! in_array($status, ['waiting', 'called', 'serving'], true),
+      ])>{{ $status }}</span>
+    @endif
+  </span>
+@endif
diff --git a/resources/views/care/prescriptions/queue.blade.php b/resources/views/care/prescriptions/queue.blade.php
index 708d0d8..21a8096 100644
--- a/resources/views/care/prescriptions/queue.blade.php
+++ b/resources/views/care/prescriptions/queue.blade.php
@@ -1,12 +1,30 @@
 <x-app-layout title="Pharmacy queue">
     <h1 class="text-xl font-semibold text-slate-900">Pharmacy queue</h1>
     <p class="mt-1 text-sm text-slate-500">Active prescriptions awaiting dispensing</p>
+
+    <div class="mt-4">
+        @include('care.partials.queue-ops', [
+            'queueIntegration' => $queueIntegration ?? null,
+            'queueCallNextRoute' => 'care.prescriptions.call-next',
+            'queueCallNextParams' => [],
+            'branchId' => $branchId ?? null,
+        ])
+    </div>
+
     <div class="mt-4 space-y-3">
         @forelse ($queue as $rx)
             <div class="rounded-2xl border border-slate-200 bg-white p-4">
                 <div class="flex items-start justify-between gap-4">
                     <div class="min-w-0 flex-1">
-                        <p class="font-medium text-slate-900">{{ $rx->patient->fullName() }}</p>
+                        <p class="font-medium text-slate-900">
+                            @if (! empty($queueIntegration['enabled']) && $rx->queue_ticket_number)
+                                @include('care.partials.queue-ticket', [
+                                    'ticketNumber' => $rx->queue_ticket_number,
+                                    'ticketStatus' => $rx->queue_ticket_status,
+                                ])
+                            @endif
+                            {{ $rx->patient->fullName() }}
+                        </p>
                         <p class="text-xs text-slate-500">{{ $rx->patient->patient_number }} · {{ $rx->visit->branch?->name }}</p>
                         <ul class="mt-2 space-y-1 text-sm text-slate-700">
                             @foreach ($rx->items as $item)
@@ -14,6 +32,14 @@
                             @endforeach
                         </ul>
                         @if ($canDispense)
+                            <div class="mt-3 flex flex-wrap gap-2">
+                                @if (! empty($queueIntegration['enabled']) && $rx->queue_ticket_uuid && ($rx->queue_ticket_status ?? '') !== 'serving')
+                                    <form method="POST" action="{{ route('care.prescriptions.serve', $rx) }}">
+                                        @csrf
+                                        <button type="submit" class="rounded-lg bg-sky-600 px-3 py-1.5 text-xs font-medium text-white hover:bg-sky-700">Serve</button>
+                                    </form>
+                                @endif
+                            </div>
                             <form method="POST" action="{{ route('care.prescriptions.dispense', $rx) }}" class="mt-4 border-t border-slate-100 pt-4">
                                 @csrf
                                 @php $allocIndex = 0; @endphp
@@ -41,7 +67,9 @@
                                     @endif
                                 @endforeach
                                 <div class="mt-3 flex gap-2">
-                                    <button type="submit" class="rounded-lg bg-emerald-600 px-3 py-1.5 text-xs font-medium text-white hover:bg-emerald-700">Dispense</button>
+                                    <button type="submit" class="rounded-lg bg-emerald-600 px-3 py-1.5 text-xs font-medium text-white hover:bg-emerald-700">
+                                        {{ ! empty($queueIntegration['enabled']) ? 'Complete & dispense' : 'Dispense' }}
+                                    </button>
                                     <a href="{{ route('care.prescriptions.show', $rx) }}" class="text-sm text-sky-600">View details</a>
                                 </div>
                             </form>
@@ -56,8 +84,4 @@
             <p class="rounded-2xl border border-dashed border-slate-200 bg-white p-8 text-center text-sm text-slate-500">No prescriptions in queue.</p>
         @endforelse
     </div>
-
-    <div class="mt-6">
-        @include('care.service-queues._panel')
-    </div>
 </x-app-layout>
diff --git a/resources/views/care/queue/index.blade.php b/resources/views/care/queue/index.blade.php
index 045a2b0..dc114e3 100644
--- a/resources/views/care/queue/index.blade.php
+++ b/resources/views/care/queue/index.blade.php
@@ -31,15 +31,32 @@
             <button type="submit" class="btn-primary">Filter</button>
         </form>
 
+        @include('care.partials.queue-ops', [
+            'queueIntegration' => $queueIntegration ?? null,
+            'queueCallNextRoute' => 'care.queue.call-next',
+            'queueCallNextParams' => [],
+            'branchId' => $branchId,
+        ])
+
         <div class="grid gap-6 lg:grid-cols-2">
             <section class="rounded-2xl border border-slate-200 bg-white p-6">
                 <h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Waiting ({{ $queue->count() }})</h2>
                 <div class="mt-4 space-y-3">
                     @forelse ($queue as $appointment)
-                        <div class="flex items-center justify-between rounded-xl border border-slate-100 bg-slate-50 p-4">
+                        <div @class([
+                            'flex items-center justify-between rounded-xl border p-4',
+                            'border-indigo-200 bg-indigo-50/60' => ($appointment->queue_ticket_status ?? null) === 'called',
+                            'border-emerald-200 bg-emerald-50' => ($appointment->queue_ticket_status ?? null) === 'serving',
+                            'border-slate-100 bg-slate-50' => ! in_array($appointment->queue_ticket_status ?? null, ['called', 'serving'], true),
+                        ])>
                             <div>
                                 <p class="font-medium text-slate-900">
-                                    @if ($appointment->queue_position)
+                                    @if (! empty($queueIntegration['enabled']) && $appointment->queue_ticket_number)
+                                        @include('care.partials.queue-ticket', [
+                                            'ticketNumber' => $appointment->queue_ticket_number,
+                                            'ticketStatus' => $appointment->queue_ticket_status,
+                                        ])
+                                    @elseif ($appointment->queue_position)
                                         <span class="mr-2 inline-flex h-6 w-6 items-center justify-center rounded-full bg-sky-100 text-xs font-bold text-sky-700">{{ $appointment->queue_position }}</span>
                                     @endif
                                     {{ $appointment->patient->fullName() }}
@@ -49,7 +66,9 @@
                             @if ($canConsult)
                                 <form method="POST" action="{{ route('care.queue.start', $appointment) }}">
                                     @csrf
-                                    <button type="submit" class="rounded-lg bg-sky-600 px-3 py-1.5 text-xs font-medium text-white hover:bg-sky-700">Start</button>
+                                    <button type="submit" class="rounded-lg bg-sky-600 px-3 py-1.5 text-xs font-medium text-white hover:bg-sky-700">
+                                        {{ ! empty($queueIntegration['enabled']) && ($appointment->queue_ticket_status ?? '') === 'called' ? 'Serve & start' : 'Start' }}
+                                    </button>
                                 </form>
                             @endif
                         </div>
@@ -65,7 +84,15 @@
                     @forelse ($inConsultation as $appointment)
                         <div class="flex items-center justify-between rounded-xl border border-emerald-100 bg-emerald-50 p-4">
                             <div>
-                                <p class="font-medium text-slate-900">{{ $appointment->patient->fullName() }}</p>
+                                <p class="font-medium text-slate-900">
+                                    @if (! empty($queueIntegration['enabled']) && $appointment->queue_ticket_number)
+                                        @include('care.partials.queue-ticket', [
+                                            'ticketNumber' => $appointment->queue_ticket_number,
+                                            'ticketStatus' => $appointment->queue_ticket_status,
+                                        ])
+                                    @endif
+                                    {{ $appointment->patient->fullName() }}
+                                </p>
                                 <p class="text-xs text-slate-500">{{ $appointment->practitioner?->name ?? 'Unassigned' }}</p>
                             </div>
                             @if ($appointment->consultation)
@@ -78,7 +105,5 @@
                 </div>
             </section>
         </div>
-
-        @include('care.service-queues._panel')
     </div>
 </x-app-layout>
diff --git a/resources/views/care/settings/edit.blade.php b/resources/views/care/settings/edit.blade.php
index 92496a3..86e6346 100644
--- a/resources/views/care/settings/edit.blade.php
+++ b/resources/views/care/settings/edit.blade.php
@@ -207,7 +207,7 @@
                     </div>
                 </x-settings.card>
 
-                <x-settings.card title="Integrations" description="Connect Ladill Queue for service counters on clinical, pharmacy, and lab pages. Requires Care Pro or Enterprise — and Care must also be enabled in Queue settings.">
+                <x-settings.card title="Integrations" description="Connect Ladill Queue so existing Care lists (patient queue, pharmacy, lab, billing, specialties) issue ticket numbers and support Call next → Serve → Complete. Requires Care Pro or Enterprise — and Care must also be enabled in Queue settings.">
                     @if (! empty($canUseQueueIntegration))
                         <label class="flex items-center gap-2 text-sm">
                             <input type="checkbox" name="queue_integration_enabled" value="1" @checked(data_get($organization->settings, 'queue_integration_enabled'))>
diff --git a/resources/views/care/specialty/show.blade.php b/resources/views/care/specialty/show.blade.php
index 22d6f6c..bc138af 100644
--- a/resources/views/care/specialty/show.blade.php
+++ b/resources/views/care/specialty/show.blade.php
@@ -42,6 +42,13 @@
             </section>
         </div>
 
+        @include('care.partials.queue-ops', [
+            'queueIntegration' => $queueIntegration ?? null,
+            'queueCallNextRoute' => 'care.specialty.call-next',
+            'queueCallNextParams' => ['module' => $moduleKey],
+            'branchId' => $branchId ?? null,
+        ])
+
         <section class="rounded-2xl border border-slate-200 bg-white p-5">
             <div class="flex items-center justify-between gap-3">
                 <h2 class="text-sm font-semibold text-slate-900">Waiting patients</h2>
@@ -51,7 +58,15 @@
                 @forelse ($waiting as $appointment)
                     <div class="flex items-center justify-between rounded-xl border border-slate-100 bg-slate-50 px-3 py-3 text-sm">
                         <div>
-                            <p class="font-medium text-slate-900">{{ $appointment->patient?->fullName() }}</p>
+                            <p class="font-medium text-slate-900">
+                                @if (! empty($queueIntegration['enabled']) && $appointment->queue_ticket_number)
+                                    @include('care.partials.queue-ticket', [
+                                        'ticketNumber' => $appointment->queue_ticket_number,
+                                        'ticketStatus' => $appointment->queue_ticket_status,
+                                    ])
+                                @endif
+                                {{ $appointment->patient?->fullName() }}
+                            </p>
                             <p class="text-xs text-slate-500">{{ $appointment->department?->name }} · {{ $appointment->practitioner?->name ?? 'Unassigned' }}</p>
                         </div>
                         <a href="{{ route('care.appointments.show', $appointment) }}" class="text-sky-600">View</a>
@@ -61,7 +76,5 @@
                 @endforelse
             </div>
         </section>
-
-        @include('care.service-queues._panel')
     </div>
 </x-app-layout>
diff --git a/routes/web.php b/routes/web.php
index e21059b..4144a15 100644
--- a/routes/web.php
+++ b/routes/web.php
@@ -88,7 +88,9 @@ Route::middleware(['auth', 'platform.session'])->group(function () {
         Route::post('/appointments/{appointment}/start-meet', [AppointmentMeetController::class, 'start'])->name('care.appointments.start-meet');
 
         Route::get('/queue', [QueueController::class, 'index'])->name('care.queue.index');
+        Route::post('/queue/call-next', [QueueController::class, 'callNext'])->name('care.queue.call-next');
         Route::post('/queue/{appointment}/start', [QueueController::class, 'start'])->name('care.queue.start');
+        Route::post('/queue/{appointment}/complete-ticket', [QueueController::class, 'completeTicket'])->name('care.queue.complete-ticket');
 
         Route::middleware('care.paid')->group(function () {
             Route::get('/service-queues', [ServiceQueueController::class, 'index'])->name('care.service-queues.index');
@@ -96,9 +98,12 @@ Route::middleware(['auth', 'platform.session'])->group(function () {
             Route::post('/service-queues/console/{counterUuid}/action', [ServiceQueueController::class, 'action'])->name('care.service-queues.action');
 
             Route::get('/specialty/{module}', [SpecialtyModuleController::class, 'show'])->name('care.specialty.show');
+            Route::post('/specialty/{module}/call-next', [SpecialtyModuleController::class, 'callNext'])->name('care.specialty.call-next');
 
             Route::get('/lab/requests', [InvestigationController::class, 'index'])->name('care.lab.requests.index');
             Route::get('/lab/queue', [InvestigationController::class, 'queue'])->name('care.lab.queue.index');
+            Route::post('/lab/queue/call-next', [InvestigationController::class, 'callNext'])->name('care.lab.queue.call-next');
+            Route::post('/lab/queue/{investigation}/serve', [InvestigationController::class, 'serve'])->name('care.lab.queue.serve');
             Route::get('/lab/requests/{investigation}', [InvestigationController::class, 'show'])->name('care.lab.requests.show');
             Route::post('/consultations/{consultation}/investigations', [InvestigationController::class, 'requestFromConsultation'])->name('care.lab.requests.store');
             Route::post('/lab/requests/{investigation}/collect-sample', [InvestigationController::class, 'collectSample'])->name('care.lab.requests.collect-sample');
@@ -116,6 +121,8 @@ Route::middleware(['auth', 'platform.session'])->group(function () {
 
             Route::get('/prescriptions', [PrescriptionController::class, 'index'])->name('care.prescriptions.index');
             Route::get('/prescriptions/queue', [PrescriptionController::class, 'queue'])->name('care.prescriptions.queue');
+            Route::post('/prescriptions/queue/call-next', [PrescriptionController::class, 'callNext'])->name('care.prescriptions.call-next');
+            Route::post('/prescriptions/{prescription}/serve', [PrescriptionController::class, 'serve'])->name('care.prescriptions.serve');
             Route::get('/consultations/{consultation}/prescriptions/create', [PrescriptionController::class, 'create'])->name('care.prescriptions.create');
             Route::post('/consultations/{consultation}/prescriptions', [PrescriptionController::class, 'store'])->name('care.prescriptions.store');
             Route::get('/prescriptions/{prescription}', [PrescriptionController::class, 'show'])->name('care.prescriptions.show');
@@ -124,6 +131,8 @@ Route::middleware(['auth', 'platform.session'])->group(function () {
             Route::post('/prescriptions/{prescription}/cancel', [PrescriptionController::class, 'cancel'])->name('care.prescriptions.cancel');
 
             Route::get('/bills', [BillController::class, 'index'])->name('care.bills.index');
+            Route::post('/bills/call-next', [BillController::class, 'callNext'])->name('care.bills.call-next');
+            Route::post('/bills/{bill}/serve', [BillController::class, 'serve'])->name('care.bills.serve');
             Route::post('/visits/{visit}/bill', [BillController::class, 'generate'])->name('care.bills.generate');
             Route::get('/bills/payments/callback', [BillController::class, 'paymentCallback'])->name('care.bills.payments.callback');
             Route::get('/bills/{bill}', [BillController::class, 'show'])->name('care.bills.show');
diff --git a/tests/Feature/CareNaturalQueueTest.php b/tests/Feature/CareNaturalQueueTest.php
index 5e9f444..8aa5ff1 100644
--- a/tests/Feature/CareNaturalQueueTest.php
+++ b/tests/Feature/CareNaturalQueueTest.php
@@ -8,9 +8,11 @@ use App\Models\Member;
 use App\Models\Organization;
 use App\Models\User;
 use Illuminate\Foundation\Testing\RefreshDatabase;
-use Illuminate\Support\Facades\Http;
 use Tests\TestCase;
 
+/**
+ * Natural list UX: no bolted-on Service counter panels; Queue ops live on role lists when enabled.
+ */
 class CareNaturalQueueTest extends TestCase
 {
     use RefreshDatabase;
@@ -45,6 +47,38 @@ class CareNaturalQueueTest extends TestCase
                 'plan' => 'pro',
                 'plan_expires_at' => now()->addMonth()->toIso8601String(),
                 'queue_integration_enabled' => true,
+                'department_queue_provisioning' => [
+                    'consultation' => [
+                        'queues' => [[
+                            'branch_id' => 1,
+                            'name' => 'Consultation',
+                            'active' => true,
+                            'synced' => true,
+                            'queue_uuid' => 'aaaaaaaa-aaaa-aaaa-aaaa-aaaaaaaaaaaa',
+                            'counter_uuid' => 'bbbbbbbb-bbbb-bbbb-bbbb-bbbbbbbbbbbb',
+                        ]],
+                    ],
+                    'pharmacy' => [
+                        'queues' => [[
+                            'branch_id' => 1,
+                            'name' => 'Pharmacy',
+                            'active' => true,
+                            'synced' => true,
+                            'queue_uuid' => 'cccccccc-cccc-cccc-cccc-cccccccccccc',
+                            'counter_uuid' => 'dddddddd-dddd-dddd-dddd-dddddddddddd',
+                        ]],
+                    ],
+                    'laboratory' => [
+                        'queues' => [[
+                            'branch_id' => 1,
+                            'name' => 'Laboratory',
+                            'active' => true,
+                            'synced' => true,
+                            'queue_uuid' => 'eeeeeeee-eeee-eeee-eeee-eeeeeeeeeeee',
+                            'counter_uuid' => 'ffffffff-ffff-ffff-ffff-ffffffffffff',
+                        ]],
+                    ],
+                ],
             ],
         ]);
 
@@ -55,49 +89,23 @@ class CareNaturalQueueTest extends TestCase
             'role' => 'hospital_admin',
         ]);
 
-        Branch::create([
+        $branch = Branch::create([
             'owner_ref' => $this->owner->public_id,
             'organization_id' => $this->organization->id,
             'name' => 'Main',
             'is_active' => true,
         ]);
-    }
 
-    protected function fakeQueueApi(): void
-    {
-        Http::fake(function (\Illuminate\Http\Client\Request $request) {
-            $url = $request->url();
-            if (str_contains($url, '/counters/') && str_contains($url, '/console')) {
-                return Http::response([
-                    'data' => [
-                        'counter' => ['name' => 'Reception desk', 'branch' => 'Main', 'status' => 'available'],
-                        'current_ticket' => null,
-                        'queues' => [['uuid' => '22222222-2222-2222-2222-222222222222', 'name' => 'Consultation']],
-                        'waiting_by_queue' => [],
-                        'transfer_queues' => [],
-                    ],
-                ], 200);
-            }
-            if (str_contains($url, '/counters')) {
-                return Http::response([
-                    'data' => [[
-                        'uuid' => '11111111-1111-1111-1111-111111111111',
-                        'name' => 'Reception desk',
-                        'branch' => 'Main',
-                        'status' => 'available',
-                        'queues' => [['uuid' => '22222222-2222-2222-2222-222222222222', 'name' => 'Consultation']],
-                    ]],
-                ], 200);
-            }
-
-            return Http::response(['message' => 'unexpected '.$url], 500);
-        });
+        // Keep provisioning stubs aligned with the created branch id.
+        $settings = $this->organization->settings;
+        foreach (['consultation', 'pharmacy', 'laboratory'] as $ctx) {
+            $settings['department_queue_provisioning'][$ctx]['queues'][0]['branch_id'] = $branch->id;
+        }
+        $this->organization->update(['settings' => $settings]);
     }
 
     public function test_sidebar_does_not_show_service_queues_nav(): void
     {
-        $this->fakeQueueApi();
-
         $this->actingAs($this->owner)
             ->get(route('care.dashboard'))
             ->assertOk()
@@ -111,89 +119,70 @@ class CareNaturalQueueTest extends TestCase
             ->assertRedirect(route('care.queue.index'));
     }
 
-    public function test_clinical_queue_embeds_service_counter_panel(): void
+    public function test_clinical_queue_shows_inline_ops_not_service_counter(): void
     {
-        $this->fakeQueueApi();
-
         $this->actingAs($this->owner)
             ->get(route('care.queue.index'))
             ->assertOk()
-            ->assertSee('Service counter')
-            ->assertSee('Reception desk')
+            ->assertDontSee('Service counter')
             ->assertSee('Call next');
     }
 
-    public function test_pharmacist_sees_queue_panel_on_pharmacy_page(): void
+    public function test_pharmacist_sees_call_next_on_pharmacy_page(): void
     {
-        $this->fakeQueueApi();
-
         Member::query()->where('user_ref', $this->owner->public_id)->update(['role' => 'pharmacist']);
 
         $this->actingAs($this->owner)
             ->get(route('care.prescriptions.queue'))
             ->assertOk()
-            ->assertSee('Service counter');
+            ->assertDontSee('Service counter')
+            ->assertSee('Call next');
     }
 
-    public function test_lab_page_embeds_service_counter_when_integration_on(): void
+    public function test_lab_page_shows_call_next_when_integration_on(): void
     {
-        $this->fakeQueueApi();
-
         Member::query()->where('user_ref', $this->owner->public_id)->update(['role' => 'lab_technician']);
 
         $this->actingAs($this->owner)
             ->get(route('care.lab.queue.index'))
             ->assertOk()
-            ->assertSee('Service counter');
+            ->assertDontSee('Service counter')
+            ->assertSee('Call next');
     }
 
-    public function test_branch_scoped_member_panel_prefers_matching_branch_counter(): void
+    public function test_integration_off_hides_queue_controls(): void
     {
-        Http::fake(function (\Illuminate\Http\Client\Request $request) {
-            $url = $request->url();
-            if (str_contains($url, '/counters/') && str_contains($url, '/console')) {
-                return Http::response([
-                    'data' => [
-                        'counter' => ['name' => 'Main reception', 'branch' => 'Main'],
-                        'current_ticket' => null,
-                        'queues' => [['uuid' => 'cccccccc-cccc-cccc-cccc-cccccccccccc', 'name' => 'Consultation']],
-                        'waiting_by_queue' => [],
-                        'transfer_queues' => [],
-                    ],
-                ], 200);
-            }
-            if (str_contains($url, '/counters')) {
-                return Http::response([
-                    'data' => [
-                        [
-                            'uuid' => 'aaaaaaaa-aaaa-aaaa-aaaa-aaaaaaaaaaaa',
-                            'name' => 'Other site desk',
-                            'branch' => 'Other',
-                            'queues' => [['name' => 'Consultation']],
-                        ],
-                        [
-                            'uuid' => 'bbbbbbbb-bbbb-bbbb-bbbb-bbbbbbbbbbbb',
-                            'name' => 'Main reception',
-                            'branch' => 'Main',
-                            'queues' => [['name' => 'Consultation']],
-                        ],
-                    ],
-                ], 200);
-            }
-
-            return Http::response(['message' => 'unexpected '.$url], 500);
-        });
-
-        $branch = Branch::query()->first();
-        Member::query()->where('user_ref', $this->owner->public_id)->update([
-            'role' => 'receptionist',
-            'branch_id' => $branch->id,
-        ]);
+        $settings = $this->organization->settings;
+        $settings['queue_integration_enabled'] = false;
+        $this->organization->update(['settings' => $settings]);
 
         $this->actingAs($this->owner)
             ->get(route('care.queue.index'))
             ->assertOk()
-            ->assertSee('Main reception')
-            ->assertDontSee('Other site desk');
+            ->assertDontSee('Call next')
+            ->assertDontSee('Service counter');
+    }
+
+    public function test_doctor_call_next_uses_consultation_queue_not_reception(): void
+    {
+        \Illuminate\Support\Facades\Http::fake([
+            '*/queues/*/call-next*' => \Illuminate\Support\Facades\Http::response([
+                'data' => [
+                    'uuid' => '77777777-7777-7777-7777-777777777777',
+                    'ticket_number' => 'C001',
+                    'status' => 'called',
+                ],
+            ], 200),
+        ]);
+
+        $branchId = Branch::query()->firstOrFail()->id;
+
+        $this->actingAs($this->owner)
+            ->post(route('care.queue.call-next'), ['branch_id' => $branchId])
+            ->assertRedirect();
+
+        \Illuminate\Support\Facades\Http::assertSent(function ($request) {
+            return str_contains($request->url(), '/queues/aaaaaaaa-aaaa-aaaa-aaaa-aaaaaaaaaaaa/call-next');
+        });
     }
 }
diff --git a/tests/Feature/CareQueueBridgeTest.php b/tests/Feature/CareQueueBridgeTest.php
new file mode 100644
index 0000000..8f77af8
--- /dev/null
+++ b/tests/Feature/CareQueueBridgeTest.php
@@ -0,0 +1,193 @@
+<?php
+
+namespace Tests\Feature;
+
+use App\Http\Middleware\EnsurePlatformSession;
+use App\Models\Appointment;
+use App\Models\Branch;
+use App\Models\Member;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\User;
+use App\Services\Care\AppointmentService;
+use App\Services\Care\CareQueueContexts;
+use Illuminate\Foundation\Testing\RefreshDatabase;
+use Illuminate\Support\Facades\Http;
+use Tests\TestCase;
+
+class CareQueueBridgeTest extends TestCase
+{
+    use RefreshDatabase;
+
+    protected User $owner;
+
+    protected Organization $organization;
+
+    protected Branch $branch;
+
+    protected Patient $patient;
+
+    protected function setUp(): void
+    {
+        parent::setUp();
+        $this->withoutMiddleware(EnsurePlatformSession::class);
+
+        config([
+            'care.queue.api_url' => 'https://queue.test/api/v1',
+            'care.queue.api_key' => 'care-test-key',
+        ]);
+
+        $this->owner = User::create([
+            'public_id' => 'bridge-owner',
+            'name' => 'Owner',
+            'email' => 'bridge@example.com',
+        ]);
+
+        $this->organization = Organization::create([
+            'owner_ref' => $this->owner->public_id,
+            'name' => 'Bridge Clinic',
+            'slug' => 'bridge-clinic',
+            'settings' => [
+                'onboarded' => true,
+                'facility_type' => 'clinic',
+                'plan' => 'pro',
+                'plan_expires_at' => now()->addMonth()->toIso8601String(),
+                'queue_integration_enabled' => true,
+            ],
+        ]);
+
+        Member::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'user_ref' => $this->owner->public_id,
+            'role' => 'hospital_admin',
+        ]);
+
+        $this->branch = Branch::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'name' => 'Main',
+            'is_active' => true,
+        ]);
+
+        $settings = $this->organization->settings;
+        $settings['department_queue_provisioning'] = [
+            CareQueueContexts::CONSULTATION => [
+                'queues' => [[
+                    'branch_id' => $this->branch->id,
+                    'branch_name' => 'Main',
+                    'name' => 'Consultation',
+                    'prefix' => 'C',
+                    'active' => true,
+                    'synced' => true,
+                    'queue_uuid' => 'aaaaaaaa-aaaa-aaaa-aaaa-aaaaaaaaaaaa',
+                    'counter_uuid' => 'bbbbbbbb-bbbb-bbbb-bbbb-bbbbbbbbbbbb',
+                    'queue_external_key' => CareQueueContexts::queueExternalKey(CareQueueContexts::CONSULTATION, $this->branch->id),
+                    'counter_external_key' => CareQueueContexts::counterExternalKey(CareQueueContexts::CONSULTATION, $this->branch->id),
+                ]],
+            ],
+        ];
+        $this->organization->update(['settings' => $settings]);
+
+        $this->patient = Patient::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_number' => 'P-100',
+            'first_name' => 'Ada',
+            'last_name' => 'Lovelace',
+            'gender' => 'female',
+            'date_of_birth' => '1990-01-01',
+        ]);
+    }
+
+    public function test_check_in_issues_consultation_ticket_when_integration_on(): void
+    {
+        Http::fake(function (\Illuminate\Http\Client\Request $request) {
+            if (str_contains($request->url(), '/tickets') && $request->method() === 'POST') {
+                return Http::response([
+                    'data' => [
+                        'uuid' => 'cccccccc-cccc-cccc-cccc-cccccccccccc',
+                        'ticket_number' => 'C001',
+                        'status' => 'waiting',
+                    ],
+                ], 201);
+            }
+
+            return Http::response(['message' => 'unexpected '.$request->url()], 500);
+        });
+
+        $appointment = Appointment::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'type' => Appointment::TYPE_SCHEDULED,
+            'status' => Appointment::STATUS_SCHEDULED,
+            'scheduled_at' => now()->addHour(),
+        ]);
+
+        $result = app(AppointmentService::class)->checkIn($appointment, $this->owner->public_id, $this->owner->public_id);
+
+        $this->assertSame('C001', $result->queue_ticket_number);
+        $this->assertSame('waiting', $result->queue_ticket_status);
+        $this->assertSame('cccccccc-cccc-cccc-cccc-cccccccccccc', $result->queue_ticket_uuid);
+
+        Http::assertSent(fn ($request) => str_contains($request->url(), '/tickets')
+            && ($request['service_queue_id'] ?? null) === 'aaaaaaaa-aaaa-aaaa-aaaa-aaaaaaaaaaaa'
+            && ($request['customer_name'] ?? null) === 'Ada Lovelace');
+    }
+
+    public function test_check_in_skips_ticket_when_integration_off(): void
+    {
+        Http::fake();
+
+        $settings = $this->organization->settings;
+        $settings['queue_integration_enabled'] = false;
+        $this->organization->update(['settings' => $settings]);
+
+        $appointment = Appointment::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'type' => Appointment::TYPE_SCHEDULED,
+            'status' => Appointment::STATUS_SCHEDULED,
+            'scheduled_at' => now()->addHour(),
+        ]);
+
+        $result = app(AppointmentService::class)->checkIn(
+            $appointment->fresh(['organization', 'patient']),
+            $this->owner->public_id,
+            $this->owner->public_id,
+        );
+
+        $this->assertNull($result->queue_ticket_uuid);
+        Http::assertNothingSent();
+    }
+
+    public function test_waiting_list_shows_ticket_number_when_integration_on(): void
+    {
+        Appointment::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'type' => Appointment::TYPE_WALK_IN,
+            'status' => Appointment::STATUS_WAITING,
+            'scheduled_at' => now(),
+            'waiting_at' => now(),
+            'queue_position' => 1,
+            'queue_ticket_uuid' => 'dddddddd-dddd-dddd-dddd-dddddddddddd',
+            'queue_ticket_number' => 'C042',
+            'queue_ticket_status' => 'waiting',
+        ]);
+
+        $this->actingAs($this->owner)
+            ->get(route('care.queue.index'))
+            ->assertOk()
+            ->assertSee('C042')
+            ->assertSee('Call next')
+            ->assertSee('Serve');
+    }
+}
diff --git a/tests/Feature/CareQueueWorkflowTest.php b/tests/Feature/CareQueueWorkflowTest.php
new file mode 100644
index 0000000..9803912
--- /dev/null
+++ b/tests/Feature/CareQueueWorkflowTest.php
@@ -0,0 +1,361 @@
+<?php
+
+namespace Tests\Feature;
+
+use App\Http\Middleware\EnsurePlatformSession;
+use App\Models\Appointment;
+use App\Models\Branch;
+use App\Models\Member;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\Prescription;
+use App\Models\User;
+use App\Models\Visit;
+use App\Services\Care\AppointmentService;
+use App\Services\Care\CareQueueBridge;
+use App\Services\Care\CareQueueContexts;
+use Illuminate\Foundation\Testing\RefreshDatabase;
+use Illuminate\Support\Facades\Http;
+use Illuminate\Support\Str;
+use Tests\TestCase;
+
+class CareQueueWorkflowTest extends TestCase
+{
+    use RefreshDatabase;
+
+    protected User $owner;
+
+    protected Organization $organization;
+
+    protected Branch $branch;
+
+    protected function setUp(): void
+    {
+        parent::setUp();
+        $this->withoutMiddleware(EnsurePlatformSession::class);
+
+        config([
+            'care.queue.api_url' => 'https://queue.test/api/v1',
+            'care.queue.api_key' => 'care-test-key',
+        ]);
+
+        $this->owner = User::create([
+            'public_id' => 'care-queue-workflow-owner',
+            'name' => 'Owner',
+            'email' => 'queue-workflow@example.com',
+        ]);
+
+        $this->organization = Organization::create([
+            'owner_ref' => $this->owner->public_id,
+            'name' => 'Workflow Clinic',
+            'slug' => 'workflow-clinic',
+            'settings' => [
+                'onboarded' => true,
+                'facility_type' => 'clinic',
+                'plan' => 'pro',
+                'plan_expires_at' => now()->addMonth()->toIso8601String(),
+                'queue_integration_enabled' => true,
+            ],
+        ]);
+
+        Member::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'user_ref' => $this->owner->public_id,
+            'role' => 'hospital_admin',
+        ]);
+
+        $this->branch = Branch::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'name' => 'Main',
+            'is_active' => true,
+        ]);
+    }
+
+    protected function fakeQueueApi(): void
+    {
+        $consultationQueue = 'aaaaaaaa-aaaa-aaaa-aaaa-aaaaaaaaaaaa';
+        $pharmacyQueue = 'bbbbbbbb-bbbb-bbbb-bbbb-bbbbbbbbbbbb';
+        $consultationCounter = 'cccccccc-cccc-cccc-cccc-cccccccccccc';
+        $pharmacyCounter = 'dddddddd-dddd-dddd-dddd-dddddddddddd';
+        $seq = ['C' => 0, 'P' => 0];
+
+        Http::fake(function (\Illuminate\Http\Client\Request $request) use (
+            $consultationQueue,
+            $pharmacyQueue,
+            $consultationCounter,
+            $pharmacyCounter,
+            &$seq,
+        ) {
+            $url = $request->url();
+            $method = $request->method();
+
+            if (str_contains($url, '/integrations/status')) {
+                return Http::response([
+                    'data' => [
+                        'provisioned' => true,
+                        'integrations' => ['care' => true],
+                    ],
+                ], 200);
+            }
+
+            if ($method === 'POST' && str_contains($url, '/branches')) {
+                return Http::response(['data' => ['id' => 1, 'name' => 'Main']], 201);
+            }
+
+            if ($method === 'POST' && str_contains($url, '/queues') && ! str_contains($url, 'call-next')) {
+                $payload = $request->data();
+                $key = (string) ($payload['external_key'] ?? '');
+                $isPharmacy = str_contains($key, 'pharmacy');
+                return Http::response([
+                    'data' => [
+                        'uuid' => $isPharmacy ? $pharmacyQueue : $consultationQueue,
+                        'name' => $payload['name'] ?? 'Queue',
+                        'prefix' => $payload['prefix'] ?? 'X',
+                    ],
+                ], 201);
+            }
+
+            if ($method === 'POST' && str_contains($url, '/counters')) {
+                $payload = $request->data();
+                $key = (string) ($payload['external_key'] ?? '');
+                $isPharmacy = str_contains($key, 'pharmacy');
+                return Http::response([
+                    'data' => [
+                        'uuid' => $isPharmacy ? $pharmacyCounter : $consultationCounter,
+                        'name' => $payload['name'] ?? 'Counter',
+                    ],
+                ], 201);
+            }
+
+            if ($method === 'POST' && preg_match('#/tickets$#', parse_url($url, PHP_URL_PATH) ?? '')) {
+                $payload = $request->data();
+                $queueId = (string) ($payload['service_queue_id'] ?? '');
+                $prefix = $queueId === $pharmacyQueue ? 'P' : 'C';
+                $seq[$prefix]++;
+                return Http::response([
+                    'data' => [
+                        'uuid' => (string) Str::uuid(),
+                        'ticket_number' => $prefix.sprintf('%03d', $seq[$prefix]),
+                        'status' => 'waiting',
+                        'customer_name' => $payload['customer_name'] ?? null,
+                    ],
+                ], 201);
+            }
+
+            if ($method === 'POST' && str_contains($url, '/call-next')) {
+                $path = parse_url($url, PHP_URL_PATH) ?? '';
+                $isPharmacy = str_contains($path, $pharmacyQueue);
+                return Http::response([
+                    'data' => [
+                        'uuid' => (string) Str::uuid(),
+                        'ticket_number' => $isPharmacy ? 'P001' : 'C001',
+                        'status' => 'called',
+                        'customer_name' => 'Called Patient',
+                    ],
+                ], 200);
+            }
+
+            if ($method === 'POST' && str_contains($url, '/tickets/') && str_contains($url, '/action')) {
+                $payload = $request->data();
+                return Http::response([
+                    'data' => [
+                        'uuid' => basename(dirname(parse_url($url, PHP_URL_PATH) ?? '/x/x')),
+                        'ticket_number' => 'C001',
+                        'status' => $payload['action'] === 'complete' ? 'completed' : ($payload['action'] === 'start' ? 'serving' : 'called'),
+                    ],
+                ], 200);
+            }
+
+            return Http::response(['message' => 'unexpected '.$method.' '.$url], 500);
+        });
+    }
+
+    public function test_integration_off_does_not_issue_tickets_on_check_in(): void
+    {
+        $settings = $this->organization->settings;
+        $settings['queue_integration_enabled'] = false;
+        $this->organization->update(['settings' => $settings]);
+
+        Http::fake();
+
+        $patient = Patient::create([
+            'uuid' => (string) Str::uuid(),
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_number' => 'P-1',
+            'first_name' => 'Ada',
+            'last_name' => 'Lovelace',
+        ]);
+
+        $appointment = Appointment::create([
+            'uuid' => (string) Str::uuid(),
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $patient->id,
+            'type' => Appointment::TYPE_SCHEDULED,
+            'status' => Appointment::STATUS_SCHEDULED,
+            'scheduled_at' => now(),
+        ]);
+
+        app(AppointmentService::class)->checkIn($appointment, $this->owner->public_id, $this->owner->public_id);
+
+        $appointment->refresh();
+        $this->assertNull($appointment->queue_ticket_uuid);
+        $this->assertNull($appointment->queue_ticket_number);
+        Http::assertNothingSent();
+    }
+
+    public function test_integration_on_issues_consultation_ticket_on_check_in(): void
+    {
+        $this->fakeQueueApi();
+
+        $patient = Patient::create([
+            'uuid' => (string) Str::uuid(),
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_number' => 'P-2',
+            'first_name' => 'Grace',
+            'last_name' => 'Hopper',
+        ]);
+
+        $appointment = Appointment::create([
+            'uuid' => (string) Str::uuid(),
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $patient->id,
+            'type' => Appointment::TYPE_SCHEDULED,
+            'status' => Appointment::STATUS_SCHEDULED,
+            'scheduled_at' => now(),
+        ]);
+
+        app(AppointmentService::class)->checkIn($appointment, $this->owner->public_id, $this->owner->public_id);
+
+        $appointment->refresh();
+        $this->assertNotNull($appointment->queue_ticket_uuid);
+        $this->assertSame('C001', $appointment->queue_ticket_number);
+        $this->assertSame('waiting', $appointment->queue_ticket_status);
+    }
+
+    public function test_pharmacy_call_next_uses_pharmacy_queue_not_reception(): void
+    {
+        $this->fakeQueueApi();
+
+        $this->organization->update([
+            'settings' => array_merge($this->organization->settings ?? [], [
+                'department_queue_provisioning' => [
+                    CareQueueContexts::PHARMACY => [
+                        'queues' => [[
+                            'branch_id' => $this->branch->id,
+                            'branch_name' => 'Main',
+                            'name' => 'Pharmacy',
+                            'prefix' => 'P',
+                            'active' => true,
+                            'synced' => true,
+                            'queue_uuid' => 'bbbbbbbb-bbbb-bbbb-bbbb-bbbbbbbbbbbb',
+                            'counter_uuid' => 'dddddddd-dddd-dddd-dddd-dddddddddddd',
+                            'queue_external_key' => CareQueueContexts::queueExternalKey(CareQueueContexts::PHARMACY, $this->branch->id),
+                            'counter_external_key' => CareQueueContexts::counterExternalKey(CareQueueContexts::PHARMACY, $this->branch->id),
+                        ]],
+                    ],
+                ],
+            ]),
+        ]);
+
+        Member::query()->where('user_ref', $this->owner->public_id)->update(['role' => 'pharmacist']);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.prescriptions.call-next'), ['branch_id' => $this->branch->id])
+            ->assertRedirect();
+
+        Http::assertSent(function (\Illuminate\Http\Client\Request $request) {
+            return $request->method() === 'POST'
+                && str_contains($request->url(), '/queues/bbbbbbbb-bbbb-bbbb-bbbb-bbbbbbbbbbbb/call-next');
+        });
+    }
+
+    public function test_complete_advances_ticket_status_on_appointment(): void
+    {
+        $this->fakeQueueApi();
+
+        $patient = Patient::create([
+            'uuid' => (string) Str::uuid(),
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_number' => 'P-3',
+            'first_name' => 'Alan',
+            'last_name' => 'Turing',
+        ]);
+
+        $appointment = Appointment::create([
+            'uuid' => (string) Str::uuid(),
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $patient->id,
+            'type' => Appointment::TYPE_WALK_IN,
+            'status' => Appointment::STATUS_WAITING,
+            'queue_ticket_uuid' => 'eeeeeeee-eeee-eeee-eeee-eeeeeeeeeeee',
+            'queue_ticket_number' => 'C009',
+            'queue_ticket_status' => 'serving',
+            'scheduled_at' => now(),
+        ]);
+
+        app(CareQueueBridge::class)->complete($this->organization, $appointment);
+        $appointment->refresh();
+
+        $this->assertSame('completed', $appointment->queue_ticket_status);
+    }
+
+    public function test_patient_queue_shows_call_next_not_service_counter_panel(): void
+    {
+        $this->fakeQueueApi();
+
+        $this->organization->update([
+            'settings' => array_merge($this->organization->settings ?? [], [
+                'department_queue_provisioning' => [
+                    CareQueueContexts::CONSULTATION => [
+                        'queues' => [[
+                            'branch_id' => $this->branch->id,
+                            'branch_name' => 'Main',
+                            'name' => 'Consultation',
+                            'prefix' => 'C',
+                            'active' => true,
+                            'synced' => true,
+                            'queue_uuid' => 'aaaaaaaa-aaaa-aaaa-aaaa-aaaaaaaaaaaa',
+                            'counter_uuid' => 'cccccccc-cccc-cccc-cccc-cccccccccccc',
+                        ]],
+                    ],
+                ],
+            ]),
+        ]);
+
+        $this->actingAs($this->owner)
+            ->get(route('care.queue.index'))
+            ->assertOk()
+            ->assertDontSee('Service counter')
+            ->assertSee('Call next')
+            ->assertSee('tickets are for this department only', false);
+    }
+
+    public function test_integration_off_hides_queue_ops_on_pharmacy_page(): void
+    {
+        $settings = $this->organization->settings;
+        $settings['queue_integration_enabled'] = false;
+        $this->organization->update(['settings' => $settings]);
+
+        Member::query()->where('user_ref', $this->owner->public_id)->update(['role' => 'pharmacist']);
+
+        $this->actingAs($this->owner)
+            ->get(route('care.prescriptions.queue'))
+            ->assertOk()
+            ->assertDontSee('Call next')
+            ->assertDontSee('Service counter');
+    }
+}