Add full Pediatrics, Orthopedics, and ENT specialty clinical suites.

Mirror Cardiology-depth stage flows, workspace tabs, reports/print, clinical
alerts, demo seeds, and PHPUnit coverage for child health, fracture clinic,
and ENT pathways.

Co-authored-by: Cursor <cursoragent@cursor.com>

app/Http/Controllers/Care/EntWorkspaceController.php

@@ -0,0 +1,215 @@
+<?php
+
+namespace App\Http\Controllers\Care;
+
+use App\Http\Controllers\Care\Concerns\ScopesToAccount;
+use App\Http\Controllers\Controller;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\Ent\EntAnalyticsService;
+use App\Services\Care\Ent\EntWorkflowService;
+use App\Services\Care\SpecialtyClinicalRecordService;
+use App\Services\Care\SpecialtyModuleService;
+use App\Services\Care\SpecialtyShellService;
+use App\Services\Care\SpecialtyVisitStageService;
+use Illuminate\Http\RedirectResponse;
+use Illuminate\Http\Request;
+use Illuminate\View\View;
+
+class EntWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertEntAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'ent'), 403);
+    }
+
+    protected function assertEntManage(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanManage($organization, $this->member($request), 'ent'), 403);
+    }
+
+    protected function assertVisit(Request $request, Visit $visit): void
+    {
+        abort_unless($visit->organization_id === $this->organization($request)->id, 404);
+        $this->authorizeBranch($request, (int) $visit->branch_id);
+    }
+
+    public function setStage(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyVisitStageService $stages,
+        SpecialtyShellService $shell,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertEntManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'ent',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', [
+                'module' => 'ent',
+                'visit' => $visit,
+                'tab' => $shell->workspaceTabForStage('ent', $validated['stage']),
+            ])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function saveProcedure(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        EntWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertEntManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('ent', 'ent_procedure') as $field) {
+            if (($field['type'] ?? '') === 'boolean') {
+                $payload[$field['name']] = $request->boolean('payload.'.$field['name']);
+            }
+        }
+        $request->merge(['payload' => $payload, 'tab' => 'procedure']);
+
+        $validated = $request->validate(array_merge([
+            'tab' => ['required', 'string'],
+        ], $clinical->validationRules('ent', 'ent_procedure')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'ent',
+            'ent_procedure',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            EntWorkflowService::STAGE_PROCEDURE,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        try {
+            $stages->setStage(
+                $organization,
+                $visit,
+                'ent',
+                EntWorkflowService::STAGE_PROCEDURE,
+                $owner,
+                $owner,
+            );
+        } catch (\InvalidArgumentException) {
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            try {
+                $stages->setStage(
+                    $organization,
+                    $visit,
+                    'ent',
+                    EntWorkflowService::STAGE_COMPLETED,
+                    $owner,
+                    $owner,
+                );
+            } catch (\InvalidArgumentException) {
+            }
+
+            $visit->refresh();
+            if ($visit->status !== Visit::STATUS_COMPLETED) {
+                $visit->update([
+                    'status' => Visit::STATUS_COMPLETED,
+                    'completed_at' => $visit->completed_at ?? now(),
+                ]);
+            }
+
+            $appointment = $visit->appointment;
+            if ($appointment && $appointment->status !== \App\Models\Appointment::STATUS_COMPLETED) {
+                $appointment->update([
+                    'status' => \App\Models\Appointment::STATUS_COMPLETED,
+                    'completed_at' => $appointment->completed_at ?? now(),
+                ]);
+            }
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'ent', 'visit' => $visit, 'tab' => 'procedure'])
+            ->with('success', 'ENT procedure saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        EntAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertEntAccess($request, $modules);
+
+        $organization = $this->organization($request);
+        $branchScope = app(\App\Services\Care\OrganizationResolver::class)->branchScope($this->member($request));
+
+        $report = $analytics->report(
+            $organization,
+            $this->ownerRef($request),
+            $branchScope,
+            $request->query('from'),
+            $request->query('to'),
+        );
+
+        return view('care.specialty.ent.reports', [
+            'moduleKey' => 'ent',
+            'definition' => $modules->definition('ent'),
+            'shellNav' => $shell->navItems('ent'),
+            'report' => $report,
+            'currency' => strtoupper((string) config('care.billing.currency', config('care.currency', 'GHS'))),
+        ]);
+    }
+
+    public function printSummary(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertEntAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.ent.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'history' => $clinical->findForVisit($visit, 'ent', 'ent_history'),
+            'exam' => $clinical->findForVisit($visit, 'ent', 'ent_exam'),
+            'investigation' => $clinical->findForVisit($visit, 'ent', 'ent_investigation'),
+            'plan' => $clinical->findForVisit($visit, 'ent', 'ent_plan'),
+            'procedure' => $clinical->findForVisit($visit, 'ent', 'ent_procedure'),
+        ]);
+    }
+}

app/Http/Controllers/Care/OrthopedicsWorkspaceController.php

@@ -0,0 +1,215 @@
+<?php
+
+namespace App\Http\Controllers\Care;
+
+use App\Http\Controllers\Care\Concerns\ScopesToAccount;
+use App\Http\Controllers\Controller;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\Orthopedics\OrthopedicsAnalyticsService;
+use App\Services\Care\Orthopedics\OrthopedicsWorkflowService;
+use App\Services\Care\SpecialtyClinicalRecordService;
+use App\Services\Care\SpecialtyModuleService;
+use App\Services\Care\SpecialtyShellService;
+use App\Services\Care\SpecialtyVisitStageService;
+use Illuminate\Http\RedirectResponse;
+use Illuminate\Http\Request;
+use Illuminate\View\View;
+
+class OrthopedicsWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertOrthopedicsAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'orthopedics'), 403);
+    }
+
+    protected function assertOrthopedicsManage(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanManage($organization, $this->member($request), 'orthopedics'), 403);
+    }
+
+    protected function assertVisit(Request $request, Visit $visit): void
+    {
+        abort_unless($visit->organization_id === $this->organization($request)->id, 404);
+        $this->authorizeBranch($request, (int) $visit->branch_id);
+    }
+
+    public function setStage(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyVisitStageService $stages,
+        SpecialtyShellService $shell,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertOrthopedicsManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'orthopedics',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', [
+                'module' => 'orthopedics',
+                'visit' => $visit,
+                'tab' => $shell->workspaceTabForStage('orthopedics', $validated['stage']),
+            ])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function saveProcedure(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        OrthopedicsWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertOrthopedicsManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('orthopedics', 'ortho_procedure') as $field) {
+            if (($field['type'] ?? '') === 'boolean') {
+                $payload[$field['name']] = $request->boolean('payload.'.$field['name']);
+            }
+        }
+        $request->merge(['payload' => $payload, 'tab' => 'procedure']);
+
+        $validated = $request->validate(array_merge([
+            'tab' => ['required', 'string'],
+        ], $clinical->validationRules('orthopedics', 'ortho_procedure')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'orthopedics',
+            'ortho_procedure',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            OrthopedicsWorkflowService::STAGE_PROCEDURE,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        try {
+            $stages->setStage(
+                $organization,
+                $visit,
+                'orthopedics',
+                OrthopedicsWorkflowService::STAGE_PROCEDURE,
+                $owner,
+                $owner,
+            );
+        } catch (\InvalidArgumentException) {
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            try {
+                $stages->setStage(
+                    $organization,
+                    $visit,
+                    'orthopedics',
+                    OrthopedicsWorkflowService::STAGE_COMPLETED,
+                    $owner,
+                    $owner,
+                );
+            } catch (\InvalidArgumentException) {
+            }
+
+            $visit->refresh();
+            if ($visit->status !== Visit::STATUS_COMPLETED) {
+                $visit->update([
+                    'status' => Visit::STATUS_COMPLETED,
+                    'completed_at' => $visit->completed_at ?? now(),
+                ]);
+            }
+
+            $appointment = $visit->appointment;
+            if ($appointment && $appointment->status !== \App\Models\Appointment::STATUS_COMPLETED) {
+                $appointment->update([
+                    'status' => \App\Models\Appointment::STATUS_COMPLETED,
+                    'completed_at' => $appointment->completed_at ?? now(),
+                ]);
+            }
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'orthopedics', 'visit' => $visit, 'tab' => 'procedure'])
+            ->with('success', 'Procedure / cast saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        OrthopedicsAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertOrthopedicsAccess($request, $modules);
+
+        $organization = $this->organization($request);
+        $branchScope = app(\App\Services\Care\OrganizationResolver::class)->branchScope($this->member($request));
+
+        $report = $analytics->report(
+            $organization,
+            $this->ownerRef($request),
+            $branchScope,
+            $request->query('from'),
+            $request->query('to'),
+        );
+
+        return view('care.specialty.orthopedics.reports', [
+            'moduleKey' => 'orthopedics',
+            'definition' => $modules->definition('orthopedics'),
+            'shellNav' => $shell->navItems('orthopedics'),
+            'report' => $report,
+            'currency' => strtoupper((string) config('care.billing.currency', config('care.currency', 'GHS'))),
+        ]);
+    }
+
+    public function printSummary(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertOrthopedicsAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.orthopedics.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'history' => $clinical->findForVisit($visit, 'orthopedics', 'ortho_history'),
+            'exam' => $clinical->findForVisit($visit, 'orthopedics', 'ortho_exam'),
+            'imaging' => $clinical->findForVisit($visit, 'orthopedics', 'ortho_imaging'),
+            'plan' => $clinical->findForVisit($visit, 'orthopedics', 'ortho_plan'),
+            'procedure' => $clinical->findForVisit($visit, 'orthopedics', 'ortho_procedure'),
+        ]);
+    }
+}

app/Http/Controllers/Care/PediatricsWorkspaceController.php

@@ -0,0 +1,215 @@
+<?php
+
+namespace App\Http\Controllers\Care;
+
+use App\Http\Controllers\Care\Concerns\ScopesToAccount;
+use App\Http\Controllers\Controller;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\Pediatrics\PediatricsAnalyticsService;
+use App\Services\Care\Pediatrics\PediatricsWorkflowService;
+use App\Services\Care\SpecialtyClinicalRecordService;
+use App\Services\Care\SpecialtyModuleService;
+use App\Services\Care\SpecialtyShellService;
+use App\Services\Care\SpecialtyVisitStageService;
+use Illuminate\Http\RedirectResponse;
+use Illuminate\Http\Request;
+use Illuminate\View\View;
+
+class PediatricsWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertPediatricsAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'pediatrics'), 403);
+    }
+
+    protected function assertPediatricsManage(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanManage($organization, $this->member($request), 'pediatrics'), 403);
+    }
+
+    protected function assertVisit(Request $request, Visit $visit): void
+    {
+        abort_unless($visit->organization_id === $this->organization($request)->id, 404);
+        $this->authorizeBranch($request, (int) $visit->branch_id);
+    }
+
+    public function setStage(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyVisitStageService $stages,
+        SpecialtyShellService $shell,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertPediatricsManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'pediatrics',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', [
+                'module' => 'pediatrics',
+                'visit' => $visit,
+                'tab' => $shell->workspaceTabForStage('pediatrics', $validated['stage']),
+            ])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function saveTreatment(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        PediatricsWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertPediatricsManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('pediatrics', 'ped_treatment') as $field) {
+            if (($field['type'] ?? '') === 'boolean') {
+                $payload[$field['name']] = $request->boolean('payload.'.$field['name']);
+            }
+        }
+        $request->merge(['payload' => $payload, 'tab' => 'treatment']);
+
+        $validated = $request->validate(array_merge([
+            'tab' => ['required', 'string'],
+        ], $clinical->validationRules('pediatrics', 'ped_treatment')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'pediatrics',
+            'ped_treatment',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            PediatricsWorkflowService::STAGE_TREATMENT,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        try {
+            $stages->setStage(
+                $organization,
+                $visit,
+                'pediatrics',
+                PediatricsWorkflowService::STAGE_TREATMENT,
+                $owner,
+                $owner,
+            );
+        } catch (\InvalidArgumentException) {
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            try {
+                $stages->setStage(
+                    $organization,
+                    $visit,
+                    'pediatrics',
+                    PediatricsWorkflowService::STAGE_COMPLETED,
+                    $owner,
+                    $owner,
+                );
+            } catch (\InvalidArgumentException) {
+            }
+
+            $visit->refresh();
+            if ($visit->status !== Visit::STATUS_COMPLETED) {
+                $visit->update([
+                    'status' => Visit::STATUS_COMPLETED,
+                    'completed_at' => $visit->completed_at ?? now(),
+                ]);
+            }
+
+            $appointment = $visit->appointment;
+            if ($appointment && $appointment->status !== \App\Models\Appointment::STATUS_COMPLETED) {
+                $appointment->update([
+                    'status' => \App\Models\Appointment::STATUS_COMPLETED,
+                    'completed_at' => $appointment->completed_at ?? now(),
+                ]);
+            }
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'pediatrics', 'visit' => $visit, 'tab' => 'treatment'])
+            ->with('success', 'Treatment / immunization saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        PediatricsAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertPediatricsAccess($request, $modules);
+
+        $organization = $this->organization($request);
+        $branchScope = app(\App\Services\Care\OrganizationResolver::class)->branchScope($this->member($request));
+
+        $report = $analytics->report(
+            $organization,
+            $this->ownerRef($request),
+            $branchScope,
+            $request->query('from'),
+            $request->query('to'),
+        );
+
+        return view('care.specialty.pediatrics.reports', [
+            'moduleKey' => 'pediatrics',
+            'definition' => $modules->definition('pediatrics'),
+            'shellNav' => $shell->navItems('pediatrics'),
+            'report' => $report,
+            'currency' => strtoupper((string) config('care.billing.currency', config('care.currency', 'GHS'))),
+        ]);
+    }
+
+    public function printSummary(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertPediatricsAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.pediatrics.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'history' => $clinical->findForVisit($visit, 'pediatrics', 'ped_history'),
+            'exam' => $clinical->findForVisit($visit, 'pediatrics', 'pediatric_exam'),
+            'investigation' => $clinical->findForVisit($visit, 'pediatrics', 'ped_investigation'),
+            'plan' => $clinical->findForVisit($visit, 'pediatrics', 'ped_plan'),
+            'treatment' => $clinical->findForVisit($visit, 'pediatrics', 'ped_treatment'),
+        ]);
+    }
+}

app/Http/Controllers/Care/SpecialtyModuleController.php

@@ -159,6 +159,9 @@ class SpecialtyModuleController extends Controller
                 'radiology' => 'protocol',
                 'cardiology' => 'history',
                 'psychiatry' => 'history',
+                'pediatrics' => 'history',
+                'orthopedics' => 'history',
+                'ent' => 'history',
                 default => (collect(array_keys($shellTabs))
                     ->first(fn (string $tab) => $clinical->recordTypeForTab($module, $tab) !== null)
                     ?? 'clinical_notes'),
@@ -236,6 +239,9 @@ class SpecialtyModuleController extends Controller
             'radiology' => 'protocol',
             'cardiology' => 'history',
             'psychiatry' => 'history',
+            'pediatrics' => 'history',
+            'orthopedics' => 'history',
+            'ent' => 'history',
             default => (collect(array_keys($shellTabs))
                 ->first(fn (string $tab) => $clinical->recordTypeForTab($module, $tab) !== null)
                 ?? 'clinical_notes'),
@@ -656,6 +662,150 @@ class SpecialtyModuleController extends Controller
             }
         }
 
+        if ($module === 'pediatrics' && in_array($recordType, ['ped_history', 'pediatric_exam', 'ped_investigation', 'ped_plan'], true)) {
+            $workflow = app(\App\Services\Care\Pediatrics\PediatricsWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = match ($recordType) {
+                'ped_history' => $workflow->stageFromHistory($record->payload ?? []),
+                'pediatric_exam' => $workflow->stageFromExam($record->payload ?? []),
+                'ped_investigation' => $workflow->stageFromInvestigation($record->payload ?? []),
+                'ped_plan' => $workflow->stageFromPlan($record->payload ?? []),
+                default => null,
+            };
+            $current = $visit->specialty_stage;
+            $early = ['check_in', 'waiting', null, ''];
+            $order = [
+                'check_in' => 0,
+                'history' => 1,
+                'exam' => 2,
+                'investigation' => 3,
+                'plan' => 4,
+                'treatment' => 5,
+                'completed' => 6,
+            ];
+            if ($suggested && (! $current || in_array($current, $early, true))) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'pediatrics',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            } elseif ($suggested && $suggested !== $current && ($order[$suggested] ?? 0) > ($order[$current] ?? 0)) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'pediatrics',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
+        if ($module === 'orthopedics' && in_array($recordType, ['ortho_history', 'ortho_exam', 'ortho_imaging', 'ortho_plan'], true)) {
+            $workflow = app(\App\Services\Care\Orthopedics\OrthopedicsWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = match ($recordType) {
+                'ortho_history' => $workflow->stageFromHistory($record->payload ?? []),
+                'ortho_exam' => $workflow->stageFromExam($record->payload ?? []),
+                'ortho_imaging' => $workflow->stageFromImaging($record->payload ?? []),
+                'ortho_plan' => $workflow->stageFromPlan($record->payload ?? []),
+                default => null,
+            };
+            $current = $visit->specialty_stage;
+            $early = ['check_in', 'waiting', null, ''];
+            $order = [
+                'check_in' => 0,
+                'history' => 1,
+                'exam' => 2,
+                'imaging' => 3,
+                'plan' => 4,
+                'procedure' => 5,
+                'completed' => 6,
+            ];
+            if ($suggested && (! $current || in_array($current, $early, true))) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'orthopedics',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            } elseif ($suggested && $suggested !== $current && ($order[$suggested] ?? 0) > ($order[$current] ?? 0)) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'orthopedics',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
+        if ($module === 'ent' && in_array($recordType, ['ent_history', 'ent_exam', 'ent_investigation', 'ent_plan'], true)) {
+            $workflow = app(\App\Services\Care\Ent\EntWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = match ($recordType) {
+                'ent_history' => $workflow->stageFromHistory($record->payload ?? []),
+                'ent_exam' => $workflow->stageFromExam($record->payload ?? []),
+                'ent_investigation' => $workflow->stageFromInvestigation($record->payload ?? []),
+                'ent_plan' => $workflow->stageFromPlan($record->payload ?? []),
+                default => null,
+            };
+            $current = $visit->specialty_stage;
+            $early = ['check_in', 'waiting', null, ''];
+            $order = [
+                'check_in' => 0,
+                'history' => 1,
+                'exam' => 2,
+                'investigation' => 3,
+                'plan' => 4,
+                'procedure' => 5,
+                'completed' => 6,
+            ];
+            if ($suggested && (! $current || in_array($current, $early, true))) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'ent',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            } elseif ($suggested && $suggested !== $current && ($order[$suggested] ?? 0) > ($order[$current] ?? 0)) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'ent',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
         return redirect()
             ->route('care.specialty.workspace', [
                 'module' => $module,
@@ -1091,6 +1241,27 @@ class SpecialtyModuleController extends Controller
         $psychiatryFollowup = null;
         $psychiatryStageCodes = [];
         $psychiatryStageFlow = [];
+        $pediatricsHistory = null;
+        $pediatricsExam = null;
+        $pediatricsInvestigation = null;
+        $pediatricsPlan = null;
+        $pediatricsTreatment = null;
+        $pediatricsStageCodes = [];
+        $pediatricsStageFlow = [];
+        $orthopedicsHistory = null;
+        $orthopedicsExam = null;
+        $orthopedicsImaging = null;
+        $orthopedicsPlan = null;
+        $orthopedicsProcedure = null;
+        $orthopedicsStageCodes = [];
+        $orthopedicsStageFlow = [];
+        $entHistory = null;
+        $entExam = null;
+        $entInvestigation = null;
+        $entPlan = null;
+        $entProcedure = null;
+        $entStageCodes = [];
+        $entStageFlow = [];
         $activeTab = (string) $request->query('tab', array_key_first($shell->workspaceTabs($module)) ?: 'overview');
         $clinical = app(SpecialtyClinicalRecordService::class);
 
@@ -1255,6 +1426,36 @@ class SpecialtyModuleController extends Controller
                 $psychiatryStageFlow = app(\App\Services\Care\Psychiatry\PsychiatryWorkflowService::class)->stageFlow();
             }
 
+            if ($module === 'pediatrics') {
+                $pediatricsHistory = $clinical->findForVisit($workspaceVisit, 'pediatrics', 'ped_history');
+                $pediatricsExam = $clinical->findForVisit($workspaceVisit, 'pediatrics', 'pediatric_exam');
+                $pediatricsInvestigation = $clinical->findForVisit($workspaceVisit, 'pediatrics', 'ped_investigation');
+                $pediatricsPlan = $clinical->findForVisit($workspaceVisit, 'pediatrics', 'ped_plan');
+                $pediatricsTreatment = $clinical->findForVisit($workspaceVisit, 'pediatrics', 'ped_treatment');
+                $pediatricsStageCodes = collect($shell->stages('pediatrics'))->pluck('code')->all();
+                $pediatricsStageFlow = app(\App\Services\Care\Pediatrics\PediatricsWorkflowService::class)->stageFlow();
+            }
+
+            if ($module === 'orthopedics') {
+                $orthopedicsHistory = $clinical->findForVisit($workspaceVisit, 'orthopedics', 'ortho_history');
+                $orthopedicsExam = $clinical->findForVisit($workspaceVisit, 'orthopedics', 'ortho_exam');
+                $orthopedicsImaging = $clinical->findForVisit($workspaceVisit, 'orthopedics', 'ortho_imaging');
+                $orthopedicsPlan = $clinical->findForVisit($workspaceVisit, 'orthopedics', 'ortho_plan');
+                $orthopedicsProcedure = $clinical->findForVisit($workspaceVisit, 'orthopedics', 'ortho_procedure');
+                $orthopedicsStageCodes = collect($shell->stages('orthopedics'))->pluck('code')->all();
+                $orthopedicsStageFlow = app(\App\Services\Care\Orthopedics\OrthopedicsWorkflowService::class)->stageFlow();
+            }
+
+            if ($module === 'ent') {
+                $entHistory = $clinical->findForVisit($workspaceVisit, 'ent', 'ent_history');
+                $entExam = $clinical->findForVisit($workspaceVisit, 'ent', 'ent_exam');
+                $entInvestigation = $clinical->findForVisit($workspaceVisit, 'ent', 'ent_investigation');
+                $entPlan = $clinical->findForVisit($workspaceVisit, 'ent', 'ent_plan');
+                $entProcedure = $clinical->findForVisit($workspaceVisit, 'ent', 'ent_procedure');
+                $entStageCodes = collect($shell->stages('ent'))->pluck('code')->all();
+                $entStageFlow = app(\App\Services\Care\Ent\EntWorkflowService::class)->stageFlow();
+            }
+
             if ($patientHeader !== null) {
                 $patientHeader['clinical_alerts'] = $clinicalAlerts;
             }
@@ -1382,6 +1583,27 @@ class SpecialtyModuleController extends Controller
             'psychiatryFollowup' => $psychiatryFollowup,
             'psychiatryStageCodes' => $psychiatryStageCodes,
             'psychiatryStageFlow' => $psychiatryStageFlow,
+            'pediatricsHistory' => $pediatricsHistory,
+            'pediatricsExam' => $pediatricsExam,
+            'pediatricsInvestigation' => $pediatricsInvestigation,
+            'pediatricsPlan' => $pediatricsPlan,
+            'pediatricsTreatment' => $pediatricsTreatment,
+            'pediatricsStageCodes' => $pediatricsStageCodes,
+            'pediatricsStageFlow' => $pediatricsStageFlow,
+            'orthopedicsHistory' => $orthopedicsHistory,
+            'orthopedicsExam' => $orthopedicsExam,
+            'orthopedicsImaging' => $orthopedicsImaging,
+            'orthopedicsPlan' => $orthopedicsPlan,
+            'orthopedicsProcedure' => $orthopedicsProcedure,
+            'orthopedicsStageCodes' => $orthopedicsStageCodes,
+            'orthopedicsStageFlow' => $orthopedicsStageFlow,
+            'entHistory' => $entHistory,
+            'entExam' => $entExam,
+            'entInvestigation' => $entInvestigation,
+            'entPlan' => $entPlan,
+            'entProcedure' => $entProcedure,
+            'entStageCodes' => $entStageCodes,
+            'entStageFlow' => $entStageFlow,
             'queueStubs' => $modules->queueStubsFor($organization, $module),
             'branchId' => $branchId,
             'branchLabel' => $branchLabel,

app/Services/Care/DemoTenantSeeder.php

@@ -1020,6 +1020,9 @@ class DemoTenantSeeder
         $this->seedRadiologyClinicalDemo($organization, $ownerRef);
         $this->seedCardiologyClinicalDemo($organization, $ownerRef);
         $this->seedPsychiatryClinicalDemo($organization, $ownerRef);
+        $this->seedPediatricsClinicalDemo($organization, $ownerRef);
+        $this->seedOrthopedicsClinicalDemo($organization, $ownerRef);
+        $this->seedEntClinicalDemo($organization, $ownerRef);
 
         return $count;
     }
@@ -1856,6 +1859,369 @@ class DemoTenantSeeder
         }
     }
 
+    private function seedPediatricsClinicalDemo(Organization $organization, string $ownerRef): void
+    {
+        $branchIds = Branch::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->pluck('id');
+
+        if ($branchIds->isEmpty()) {
+            return;
+        }
+
+        $departmentIds = Department::owned($ownerRef)
+            ->whereIn('branch_id', $branchIds)
+            ->where('type', 'pediatrics')
+            ->where('is_active', true)
+            ->pluck('id');
+
+        if ($departmentIds->isEmpty()) {
+            return;
+        }
+
+        $appointments = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('department_id', $departmentIds)
+            ->whereIn('status', [Appointment::STATUS_WAITING, Appointment::STATUS_CHECKED_IN])
+            ->whereNotNull('visit_id')
+            ->with('visit')
+            ->orderBy('branch_id')
+            ->orderBy('id')
+            ->get();
+
+        if ($appointments->isEmpty()) {
+            return;
+        }
+
+        $clinical = app(SpecialtyClinicalRecordService::class);
+        $index = 0;
+
+        foreach ($appointments as $appointment) {
+            $visit = $appointment->visit;
+            if (! $visit) {
+                continue;
+            }
+
+            $highRisk = $index === 0;
+            $clinical->upsert(
+                $organization,
+                $visit,
+                'pediatrics',
+                'ped_history',
+                [
+                    'history' => $highRisk
+                        ? 'Fever and poor feeding for 3 days; reduced urine output'
+                        : 'Mild cough for 1 week; eating well',
+                    'birth_history' => $highRisk ? 'Term; birth weight 2.8 kg' : 'Term; uneventful',
+                    'past_medical' => $highRisk ? 'Prior admission for pneumonia' : 'None',
+                    'medications' => 'None',
+                    'allergies' => 'NKDA',
+                    'feeding' => $highRisk ? 'Breast + formula; intake reduced' : 'Age-appropriate diet',
+                    'social' => 'Lives with parents',
+                ],
+                $ownerRef,
+                $ownerRef,
+                'history',
+            );
+
+            $clinical->upsert(
+                $organization,
+                $visit,
+                'pediatrics',
+                'pediatric_exam',
+                [
+                    'chief_complaint' => $highRisk ? 'Fever / possible sepsis' : 'Cough review',
+                    'age_months' => $highRisk ? 18 : 48,
+                    'weight_kg' => $highRisk ? 8.2 : 16.5,
+                    'height_cm' => $highRisk ? 76 : 102,
+                    'head_circumference_cm' => $highRisk ? 45 : null,
+                    'temperature_c' => $highRisk ? 39.2 : 36.8,
+                    'growth_concern' => $highRisk ? 'Underweight' : 'None',
+                    'developmental' => $highRisk ? 'Walks; few words' : 'Age-appropriate',
+                    'immunization_status' => $highRisk ? 'Up to date except measles' : 'Up to date',
+                    'examination' => $highRisk
+                        ? 'Irritable; mild dehydration; clear chest; no rash'
+                        : 'Well; mild rhinitis; chest clear',
+                ],
+                $ownerRef,
+                $ownerRef,
+                'exam',
+            );
+
+            if ($highRisk) {
+                $clinical->upsert(
+                    $organization,
+                    $visit,
+                    'pediatrics',
+                    'ped_plan',
+                    [
+                        'diagnosis' => 'Febrile illness — rule out serious bacterial infection',
+                        'plan' => 'Labs; oral fluids; antipyretic; review same day if worse',
+                        'medications' => 'Paracetamol PRN',
+                        'treatment_planned' => true,
+                        'follow_up' => '24 hours or sooner if red flags',
+                        'advice' => 'Hydration; fever advice; return if lethargy or poor feeding',
+                    ],
+                    $ownerRef,
+                    $ownerRef,
+                    'plan',
+                );
+            }
+
+            if (! $visit->specialty_stage) {
+                $visit->update(['specialty_stage' => $highRisk ? 'plan' : 'exam']);
+            }
+
+            $index++;
+        }
+    }
+
+    private function seedOrthopedicsClinicalDemo(Organization $organization, string $ownerRef): void
+    {
+        $branchIds = Branch::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->pluck('id');
+
+        if ($branchIds->isEmpty()) {
+            return;
+        }
+
+        $departmentIds = Department::owned($ownerRef)
+            ->whereIn('branch_id', $branchIds)
+            ->where('type', 'orthopedics')
+            ->where('is_active', true)
+            ->pluck('id');
+
+        if ($departmentIds->isEmpty()) {
+            return;
+        }
+
+        $appointments = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('department_id', $departmentIds)
+            ->whereIn('status', [Appointment::STATUS_WAITING, Appointment::STATUS_CHECKED_IN])
+            ->whereNotNull('visit_id')
+            ->with('visit')
+            ->orderBy('branch_id')
+            ->orderBy('id')
+            ->get();
+
+        if ($appointments->isEmpty()) {
+            return;
+        }
+
+        $clinical = app(SpecialtyClinicalRecordService::class);
+        $index = 0;
+
+        foreach ($appointments as $appointment) {
+            $visit = $appointment->visit;
+            if (! $visit) {
+                continue;
+            }
+
+            $highRisk = $index === 0;
+            $clinical->upsert(
+                $organization,
+                $visit,
+                'orthopedics',
+                'ortho_history',
+                [
+                    'history' => $highRisk
+                        ? 'Fall from height; right wrist pain and deformity'
+                        : 'Left knee pain after football twist',
+                    'mechanism' => $highRisk ? 'FOOSH from ladder' : 'Twisting injury',
+                    'past_ortho' => $highRisk ? 'Prior ankle sprain' : 'None',
+                    'medications' => 'None',
+                    'allergies' => 'NKDA',
+                    'comorbidities' => $highRisk ? 'Diabetes' : 'None',
+                ],
+                $ownerRef,
+                $ownerRef,
+                'history',
+            );
+
+            $clinical->upsert(
+                $organization,
+                $visit,
+                'orthopedics',
+                'ortho_exam',
+                [
+                    'chief_complaint' => $highRisk ? 'Wrist deformity after fall' : 'Knee pain',
+                    'side' => $highRisk ? 'Right' : 'Left',
+                    'region' => $highRisk ? 'Distal radius' : 'Knee',
+                    'rom' => $highRisk ? 'Limited wrist flexion/extension' : 'Full ROM; pain on twist',
+                    'neurovascular' => $highRisk ? 'Sensory deficit' : 'Intact',
+                    'swelling' => $highRisk ? 'Dinner-fork deformity' : 'Mild effusion',
+                    'exam_findings' => $highRisk ? 'Closed injury; soft compartments' : 'McMurray negative; stable ligaments',
+                    'fracture_classification' => $highRisk ? 'Colles-type distal radius' : 'Soft tissue strain',
+                ],
+                $ownerRef,
+                $ownerRef,
+                'exam',
+            );
+
+            if ($highRisk) {
+                $clinical->upsert(
+                    $organization,
+                    $visit,
+                    'orthopedics',
+                    'ortho_imaging',
+                    [
+                        'modality' => 'X-ray',
+                        'region' => 'Right wrist',
+                        'findings' => 'Displaced distal radius fracture; ulnar styloid intact',
+                        'impression' => 'Extra-articular distal radius fracture',
+                        'notes' => 'AP and lateral views',
+                    ],
+                    $ownerRef,
+                    $ownerRef,
+                    'imaging',
+                );
+
+                $clinical->upsert(
+                    $organization,
+                    $visit,
+                    'orthopedics',
+                    'ortho_plan',
+                    [
+                        'diagnosis' => 'Displaced distal radius fracture',
+                        'plan' => 'Closed reduction and cast; elevate; analgesia',
+                        'weight_bearing' => 'N/A — upper limb',
+                        'procedure_planned' => true,
+                        'follow_up' => '1 week with cast check / x-ray',
+                        'advice' => 'Elevation; watch for numbness or colour change',
+                    ],
+                    $ownerRef,
+                    $ownerRef,
+                    'plan',
+                );
+            }
+
+            if (! $visit->specialty_stage) {
+                $visit->update(['specialty_stage' => $highRisk ? 'plan' : 'exam']);
+            }
+
+            $index++;
+        }
+    }
+
+    private function seedEntClinicalDemo(Organization $organization, string $ownerRef): void
+    {
+        $branchIds = Branch::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->pluck('id');
+
+        if ($branchIds->isEmpty()) {
+            return;
+        }
+
+        $departmentIds = Department::owned($ownerRef)
+            ->whereIn('branch_id', $branchIds)
+            ->where('type', 'ent')
+            ->where('is_active', true)
+            ->pluck('id');
+
+        if ($departmentIds->isEmpty()) {
+            return;
+        }
+
+        $appointments = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('department_id', $departmentIds)
+            ->whereIn('status', [Appointment::STATUS_WAITING, Appointment::STATUS_CHECKED_IN])
+            ->whereNotNull('visit_id')
+            ->with('visit')
+            ->orderBy('branch_id')
+            ->orderBy('id')
+            ->get();
+
+        if ($appointments->isEmpty()) {
+            return;
+        }
+
+        $clinical = app(SpecialtyClinicalRecordService::class);
+        $index = 0;
+
+        foreach ($appointments as $appointment) {
+            $visit = $appointment->visit;
+            if (! $visit) {
+                continue;
+            }
+
+            $highRisk = $index === 0;
+            $clinical->upsert(
+                $organization,
+                $visit,
+                'ent',
+                'ent_history',
+                [
+                    'history' => $highRisk
+                        ? 'Progressive sore throat and muffled voice; difficulty swallowing'
+                        : 'Recurrent ear discharge for 2 months',
+                    'ear_symptoms' => $highRisk ? 'None' : 'Left otorrhoea; mild hearing loss',
+                    'nose_symptoms' => 'None',
+                    'throat_symptoms' => $highRisk ? 'Severe odynophagia; drooling' : 'None',
+                    'past_ent' => $highRisk ? 'Prior tonsillitis' : 'Recurrent otitis media',
+                    'medications' => $highRisk ? 'None recent' : 'Topical drops PRN',
+                    'allergies' => 'NKDA',
+                ],
+                $ownerRef,
+                $ownerRef,
+                'history',
+            );
+
+            $clinical->upsert(
+                $organization,
+                $visit,
+                'ent',
+                'ent_exam',
+                [
+                    'chief_complaint' => $highRisk ? 'Sore throat / possible peritonsillar abscess' : 'Chronic ear discharge',
+                    'ear_findings' => $highRisk ? 'Normal TMs' : 'Left canal moist; TM perforated',
+                    'nose_findings' => 'Normal',
+                    'throat_findings' => $highRisk
+                        ? 'Trismus; unilateral tonsillar bulge; uvula deviation'
+                        : 'Oropharynx normal',
+                    'hearing' => $highRisk ? 'Grossly normal' : 'Reduced left whispered voice',
+                    'neck' => $highRisk ? 'Tender cervical nodes' : 'No lymphadenopathy',
+                    'airway_concern' => $highRisk,
+                    'exam_summary' => $highRisk
+                        ? 'Findings consistent with peritonsillar abscess — airway vigilance'
+                        : 'Chronic otitis media with perforation',
+                ],
+                $ownerRef,
+                $ownerRef,
+                'exam',
+            );
+
+            if ($highRisk) {
+                $clinical->upsert(
+                    $organization,
+                    $visit,
+                    'ent',
+                    'ent_plan',
+                    [
+                        'diagnosis' => 'Suspected peritonsillar abscess',
+                        'plan' => 'IV antibiotics; needle aspiration / I&D; airway monitoring',
+                        'medications' => 'IV antibiotics per protocol; analgesia',
+                        'procedure_planned' => true,
+                        'follow_up' => 'Inpatient review post-drainage',
+                        'advice' => 'NPO until airway safe; urgent escalation if stridor',
+                    ],
+                    $ownerRef,
+                    $ownerRef,
+                    'plan',
+                );
+            }
+
+            if (! $visit->specialty_stage) {
+                $visit->update(['specialty_stage' => $highRisk ? 'plan' : 'exam']);
+            }
+
+            $index++;
+        }
+    }
+
     private function seedDentistryClinicalDemo(Organization $organization, string $ownerRef): void
     {
         // Specialty departments are provisioned without organization_id; scope via branches.

app/Services/Care/Ent/EntAnalyticsService.php

@@ -0,0 +1,164 @@
+<?php
+
+namespace App\Services\Care\Ent;
+
+use App\Models\Appointment;
+use App\Models\Bill;
+use App\Models\BillLineItem;
+use App\Models\Organization;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyShellService;
+use Carbon\Carbon;
+use Illuminate\Support\Collection;
+
+class EntAnalyticsService
+{
+    public function __construct(
+        protected SpecialtyShellService $shell,
+    ) {}
+
+    /**
+     * @return array{
+     *     arrivals_today: int,
+     *     completed_today: int,
+     *     airway_open: int,
+     *     diagnosis_breakdown: Collection,
+     *     procedure_breakdown: Collection,
+     *     avg_los_minutes: ?float,
+     *     revenue_by_service: Collection,
+     *     from: string,
+     *     to: string
+     * }
+     */
+    public function report(
+        Organization $organization,
+        string $ownerRef,
+        ?int $branchId = null,
+        ?string $from = null,
+        ?string $to = null,
+    ): array {
+        $todayStart = now()->startOfDay();
+        $rangeFrom = $from ? Carbon::parse($from)->startOfDay() : now()->startOfMonth();
+        $rangeTo = $to ? Carbon::parse($to)->endOfDay() : now()->endOfDay();
+
+        $departmentIds = $this->shell->departmentIds($organization, 'ent', $ownerRef, $branchId);
+
+        $appointmentBase = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->when($departmentIds !== [], fn ($q) => $q->whereIn('department_id', $departmentIds))
+            ->when($departmentIds === [], fn ($q) => $q->whereRaw('1 = 0'))
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId));
+
+        $arrivalsToday = (clone $appointmentBase)
+            ->where('checked_in_at', '>=', $todayStart)
+            ->count();
+
+        $completedToday = (clone $appointmentBase)
+            ->where('status', Appointment::STATUS_COMPLETED)
+            ->where('completed_at', '>=', $todayStart)
+            ->count();
+
+        $visitIds = (clone $appointmentBase)->whereNotNull('visit_id')->pluck('visit_id');
+
+        $openVisitIds = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->whereIn('status', [Visit::STATUS_OPEN, Visit::STATUS_IN_PROGRESS])
+            ->pluck('id');
+
+        $airwayOpen = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'ent')
+            ->where('record_type', 'ent_exam')
+            ->whereIn('visit_id', $openVisitIds->isEmpty() ? [0] : $openVisitIds)
+            ->get()
+            ->filter(fn (SpecialtyClinicalRecord $r) => ! empty($r->payload['airway_concern']))
+            ->count();
+
+        $planRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'ent')
+            ->where('record_type', 'ent_plan')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $diagnosisBreakdown = $planRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['diagnosis'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $diagnosis) => [
+                'diagnosis' => $diagnosis,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $procedureRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'ent')
+            ->where('record_type', 'ent_procedure')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $procedureBreakdown = $procedureRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['procedure'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $procedure) => [
+                'procedure' => $procedure,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $completedVisits = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->where('status', Visit::STATUS_COMPLETED)
+            ->whereBetween('completed_at', [$rangeFrom, $rangeTo])
+            ->whereNotNull('checked_in_at')
+            ->whereNotNull('completed_at')
+            ->get();
+
+        $avgLos = null;
+        if ($completedVisits->isNotEmpty()) {
+            $avgLos = round($completedVisits->avg(function (Visit $visit) {
+                return $visit->checked_in_at->diffInMinutes($visit->completed_at);
+            }), 1);
+        }
+
+        $serviceLabels = collect($this->shell->provisionedServices($organization, 'ent'))
+            ->pluck('label')
+            ->filter()
+            ->values()
+            ->all();
+
+        $revenueByService = BillLineItem::query()
+            ->where('owner_ref', $ownerRef)
+            ->where('source_type', 'specialty_service')
+            ->whereIn('description', $serviceLabels ?: ['__none__'])
+            ->whereBetween('created_at', [$rangeFrom, $rangeTo])
+            ->whereHas('bill', function ($q) use ($organization, $visitIds) {
+                $q->where('organization_id', $organization->id)
+                    ->whereIn('visit_id', $visitIds->isEmpty() ? [0] : $visitIds)
+                    ->whereNotIn('status', [Bill::STATUS_VOID]);
+            })
+            ->selectRaw('description, count(*) as total, sum(total_minor) as amount_minor')
+            ->groupBy('description')
+            ->orderByDesc('amount_minor')
+            ->get();
+
+        return [
+            'arrivals_today' => $arrivalsToday,
+            'completed_today' => $completedToday,
+            'airway_open' => $airwayOpen,
+            'diagnosis_breakdown' => $diagnosisBreakdown,
+            'procedure_breakdown' => $procedureBreakdown,
+            'avg_los_minutes' => $avgLos,
+            'revenue_by_service' => $revenueByService,
+            'from' => $rangeFrom->toDateString(),
+            'to' => $rangeTo->toDateString(),
+        ];
+    }
+}

app/Services/Care/Ent/EntWorkflowService.php

@@ -0,0 +1,107 @@
+<?php
+
+namespace App\Services\Care\Ent;
+
+/**
+ * Map ENT clinical progress onto visit stages.
+ */
+class EntWorkflowService
+{
+    public const STAGE_CHECK_IN = 'check_in';
+
+    public const STAGE_HISTORY = 'history';
+
+    public const STAGE_EXAM = 'exam';
+
+    public const STAGE_INVESTIGATION = 'investigation';
+
+    public const STAGE_PLAN = 'plan';
+
+    public const STAGE_PROCEDURE = 'procedure';
+
+    public const STAGE_COMPLETED = 'completed';
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromHistory(array $payload): string
+    {
+        $history = trim((string) ($payload['history'] ?? ''));
+        if ($history !== '') {
+            return self::STAGE_HISTORY;
+        }
+
+        return self::STAGE_CHECK_IN;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromExam(array $payload): string
+    {
+        if (! empty($payload['chief_complaint'])
+            || ! empty($payload['ear_findings'])
+            || ! empty($payload['nose_findings'])
+            || ! empty($payload['throat_findings'])) {
+            return self::STAGE_EXAM;
+        }
+
+        return self::STAGE_HISTORY;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromInvestigation(array $payload): string
+    {
+        $findings = trim((string) ($payload['findings'] ?? ''));
+        if ($findings !== '') {
+            return self::STAGE_INVESTIGATION;
+        }
+
+        return self::STAGE_EXAM;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromPlan(array $payload): string
+    {
+        if (! empty($payload['procedure_planned'])) {
+            return self::STAGE_PROCEDURE;
+        }
+
+        $plan = trim((string) ($payload['plan'] ?? ''));
+        if ($plan !== '') {
+            return self::STAGE_PLAN;
+        }
+
+        return self::STAGE_INVESTIGATION;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function shouldCompleteVisit(array $payload): bool
+    {
+        $outcome = strtolower((string) ($payload['outcome'] ?? ''));
+
+        return str_contains($outcome, 'completed');
+    }
+
+    /**
+     * @return array<string, array{next: string, label: string}>
+     */
+    public function stageFlow(): array
+    {
+        return [
+            self::STAGE_CHECK_IN => ['next' => self::STAGE_HISTORY, 'label' => 'Start history'],
+            self::STAGE_HISTORY => ['next' => self::STAGE_EXAM, 'label' => 'Move to exam'],
+            self::STAGE_EXAM => ['next' => self::STAGE_INVESTIGATION, 'label' => 'Move to investigations'],
+            self::STAGE_INVESTIGATION => ['next' => self::STAGE_PLAN, 'label' => 'Move to diagnosis & plan'],
+            self::STAGE_PLAN => ['next' => self::STAGE_PROCEDURE, 'label' => 'Move to procedure'],
+            self::STAGE_PROCEDURE => ['next' => self::STAGE_COMPLETED, 'label' => 'Complete visit'],
+            self::STAGE_COMPLETED => ['next' => self::STAGE_COMPLETED, 'label' => 'Completed'],
+        ];
+    }
+}

app/Services/Care/Orthopedics/OrthopedicsAnalyticsService.php

@@ -0,0 +1,168 @@
+<?php
+
+namespace App\Services\Care\Orthopedics;
+
+use App\Models\Appointment;
+use App\Models\Bill;
+use App\Models\BillLineItem;
+use App\Models\Organization;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyShellService;
+use Carbon\Carbon;
+use Illuminate\Support\Collection;
+
+class OrthopedicsAnalyticsService
+{
+    public function __construct(
+        protected SpecialtyShellService $shell,
+    ) {}
+
+    /**
+     * @return array{
+     *     arrivals_today: int,
+     *     completed_today: int,
+     *     nv_compromise_open: int,
+     *     diagnosis_breakdown: Collection,
+     *     procedure_breakdown: Collection,
+     *     avg_los_minutes: ?float,
+     *     revenue_by_service: Collection,
+     *     from: string,
+     *     to: string
+     * }
+     */
+    public function report(
+        Organization $organization,
+        string $ownerRef,
+        ?int $branchId = null,
+        ?string $from = null,
+        ?string $to = null,
+    ): array {
+        $todayStart = now()->startOfDay();
+        $rangeFrom = $from ? Carbon::parse($from)->startOfDay() : now()->startOfMonth();
+        $rangeTo = $to ? Carbon::parse($to)->endOfDay() : now()->endOfDay();
+
+        $departmentIds = $this->shell->departmentIds($organization, 'orthopedics', $ownerRef, $branchId);
+
+        $appointmentBase = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->when($departmentIds !== [], fn ($q) => $q->whereIn('department_id', $departmentIds))
+            ->when($departmentIds === [], fn ($q) => $q->whereRaw('1 = 0'))
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId));
+
+        $arrivalsToday = (clone $appointmentBase)
+            ->where('checked_in_at', '>=', $todayStart)
+            ->count();
+
+        $completedToday = (clone $appointmentBase)
+            ->where('status', Appointment::STATUS_COMPLETED)
+            ->where('completed_at', '>=', $todayStart)
+            ->count();
+
+        $visitIds = (clone $appointmentBase)->whereNotNull('visit_id')->pluck('visit_id');
+
+        $openVisitIds = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->whereIn('status', [Visit::STATUS_OPEN, Visit::STATUS_IN_PROGRESS])
+            ->pluck('id');
+
+        $nvCompromiseOpen = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'orthopedics')
+            ->where('record_type', 'ortho_exam')
+            ->whereIn('visit_id', $openVisitIds->isEmpty() ? [0] : $openVisitIds)
+            ->get()
+            ->filter(function (SpecialtyClinicalRecord $r) {
+                $nv = strtolower((string) ($r->payload['neurovascular'] ?? ''));
+
+                return str_contains($nv, 'deficit') || str_contains($nv, 'compromise');
+            })
+            ->count();
+
+        $planRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'orthopedics')
+            ->where('record_type', 'ortho_plan')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $diagnosisBreakdown = $planRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['diagnosis'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $diagnosis) => [
+                'diagnosis' => $diagnosis,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $procedureRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'orthopedics')
+            ->where('record_type', 'ortho_procedure')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $procedureBreakdown = $procedureRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['procedure'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $procedure) => [
+                'procedure' => $procedure,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $completedVisits = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->where('status', Visit::STATUS_COMPLETED)
+            ->whereBetween('completed_at', [$rangeFrom, $rangeTo])
+            ->whereNotNull('checked_in_at')
+            ->whereNotNull('completed_at')
+            ->get();
+
+        $avgLos = null;
+        if ($completedVisits->isNotEmpty()) {
+            $avgLos = round($completedVisits->avg(function (Visit $visit) {
+                return $visit->checked_in_at->diffInMinutes($visit->completed_at);
+            }), 1);
+        }
+
+        $serviceLabels = collect($this->shell->provisionedServices($organization, 'orthopedics'))
+            ->pluck('label')
+            ->filter()
+            ->values()
+            ->all();
+
+        $revenueByService = BillLineItem::query()
+            ->where('owner_ref', $ownerRef)
+            ->where('source_type', 'specialty_service')
+            ->whereIn('description', $serviceLabels ?: ['__none__'])
+            ->whereBetween('created_at', [$rangeFrom, $rangeTo])
+            ->whereHas('bill', function ($q) use ($organization, $visitIds) {
+                $q->where('organization_id', $organization->id)
+                    ->whereIn('visit_id', $visitIds->isEmpty() ? [0] : $visitIds)
+                    ->whereNotIn('status', [Bill::STATUS_VOID]);
+            })
+            ->selectRaw('description, count(*) as total, sum(total_minor) as amount_minor')
+            ->groupBy('description')
+            ->orderByDesc('amount_minor')
+            ->get();
+
+        return [
+            'arrivals_today' => $arrivalsToday,
+            'completed_today' => $completedToday,
+            'nv_compromise_open' => $nvCompromiseOpen,
+            'diagnosis_breakdown' => $diagnosisBreakdown,
+            'procedure_breakdown' => $procedureBreakdown,
+            'avg_los_minutes' => $avgLos,
+            'revenue_by_service' => $revenueByService,
+            'from' => $rangeFrom->toDateString(),
+            'to' => $rangeTo->toDateString(),
+        ];
+    }
+}

app/Services/Care/Orthopedics/OrthopedicsWorkflowService.php

@@ -0,0 +1,104 @@
+<?php
+
+namespace App\Services\Care\Orthopedics;
+
+/**
+ * Map orthopedics clinical progress onto visit stages.
+ */
+class OrthopedicsWorkflowService
+{
+    public const STAGE_CHECK_IN = 'check_in';
+
+    public const STAGE_HISTORY = 'history';
+
+    public const STAGE_EXAM = 'exam';
+
+    public const STAGE_IMAGING = 'imaging';
+
+    public const STAGE_PLAN = 'plan';
+
+    public const STAGE_PROCEDURE = 'procedure';
+
+    public const STAGE_COMPLETED = 'completed';
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromHistory(array $payload): string
+    {
+        $history = trim((string) ($payload['history'] ?? ''));
+        if ($history !== '') {
+            return self::STAGE_HISTORY;
+        }
+
+        return self::STAGE_CHECK_IN;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromExam(array $payload): string
+    {
+        if (! empty($payload['region']) || ! empty($payload['chief_complaint'])) {
+            return self::STAGE_EXAM;
+        }
+
+        return self::STAGE_HISTORY;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromImaging(array $payload): string
+    {
+        $findings = trim((string) ($payload['findings'] ?? ''));
+        if ($findings !== '') {
+            return self::STAGE_IMAGING;
+        }
+
+        return self::STAGE_EXAM;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromPlan(array $payload): string
+    {
+        if (! empty($payload['procedure_planned'])) {
+            return self::STAGE_PROCEDURE;
+        }
+
+        $plan = trim((string) ($payload['plan'] ?? ''));
+        if ($plan !== '') {
+            return self::STAGE_PLAN;
+        }
+
+        return self::STAGE_IMAGING;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function shouldCompleteVisit(array $payload): bool
+    {
+        $outcome = strtolower((string) ($payload['outcome'] ?? ''));
+
+        return str_contains($outcome, 'completed');
+    }
+
+    /**
+     * @return array<string, array{next: string, label: string}>
+     */
+    public function stageFlow(): array
+    {
+        return [
+            self::STAGE_CHECK_IN => ['next' => self::STAGE_HISTORY, 'label' => 'Start history'],
+            self::STAGE_HISTORY => ['next' => self::STAGE_EXAM, 'label' => 'Move to exam'],
+            self::STAGE_EXAM => ['next' => self::STAGE_IMAGING, 'label' => 'Move to imaging'],
+            self::STAGE_IMAGING => ['next' => self::STAGE_PLAN, 'label' => 'Move to diagnosis & plan'],
+            self::STAGE_PLAN => ['next' => self::STAGE_PROCEDURE, 'label' => 'Move to procedure / cast'],
+            self::STAGE_PROCEDURE => ['next' => self::STAGE_COMPLETED, 'label' => 'Complete visit'],
+            self::STAGE_COMPLETED => ['next' => self::STAGE_COMPLETED, 'label' => 'Completed'],
+        ];
+    }
+}

app/Services/Care/Pediatrics/PediatricsAnalyticsService.php

@@ -0,0 +1,168 @@
+<?php
+
+namespace App\Services\Care\Pediatrics;
+
+use App\Models\Appointment;
+use App\Models\Bill;
+use App\Models\BillLineItem;
+use App\Models\Organization;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyShellService;
+use Carbon\Carbon;
+use Illuminate\Support\Collection;
+
+class PediatricsAnalyticsService
+{
+    public function __construct(
+        protected SpecialtyShellService $shell,
+    ) {}
+
+    /**
+     * @return array{
+     *     arrivals_today: int,
+     *     completed_today: int,
+     *     growth_concern_open: int,
+     *     diagnosis_breakdown: Collection,
+     *     treatment_breakdown: Collection,
+     *     avg_los_minutes: ?float,
+     *     revenue_by_service: Collection,
+     *     from: string,
+     *     to: string
+     * }
+     */
+    public function report(
+        Organization $organization,
+        string $ownerRef,
+        ?int $branchId = null,
+        ?string $from = null,
+        ?string $to = null,
+    ): array {
+        $todayStart = now()->startOfDay();
+        $rangeFrom = $from ? Carbon::parse($from)->startOfDay() : now()->startOfMonth();
+        $rangeTo = $to ? Carbon::parse($to)->endOfDay() : now()->endOfDay();
+
+        $departmentIds = $this->shell->departmentIds($organization, 'pediatrics', $ownerRef, $branchId);
+
+        $appointmentBase = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->when($departmentIds !== [], fn ($q) => $q->whereIn('department_id', $departmentIds))
+            ->when($departmentIds === [], fn ($q) => $q->whereRaw('1 = 0'))
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId));
+
+        $arrivalsToday = (clone $appointmentBase)
+            ->where('checked_in_at', '>=', $todayStart)
+            ->count();
+
+        $completedToday = (clone $appointmentBase)
+            ->where('status', Appointment::STATUS_COMPLETED)
+            ->where('completed_at', '>=', $todayStart)
+            ->count();
+
+        $visitIds = (clone $appointmentBase)->whereNotNull('visit_id')->pluck('visit_id');
+
+        $openVisitIds = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->whereIn('status', [Visit::STATUS_OPEN, Visit::STATUS_IN_PROGRESS])
+            ->pluck('id');
+
+        $growthConcernOpen = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'pediatrics')
+            ->where('record_type', 'pediatric_exam')
+            ->whereIn('visit_id', $openVisitIds->isEmpty() ? [0] : $openVisitIds)
+            ->get()
+            ->filter(function (SpecialtyClinicalRecord $r) {
+                $concern = (string) ($r->payload['growth_concern'] ?? '');
+
+                return $concern !== '' && $concern !== 'None';
+            })
+            ->count();
+
+        $planRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'pediatrics')
+            ->where('record_type', 'ped_plan')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $diagnosisBreakdown = $planRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['diagnosis'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $diagnosis) => [
+                'diagnosis' => $diagnosis,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $treatmentRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'pediatrics')
+            ->where('record_type', 'ped_treatment')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $treatmentBreakdown = $treatmentRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['treatment'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $treatment) => [
+                'treatment' => $treatment,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $completedVisits = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->where('status', Visit::STATUS_COMPLETED)
+            ->whereBetween('completed_at', [$rangeFrom, $rangeTo])
+            ->whereNotNull('checked_in_at')
+            ->whereNotNull('completed_at')
+            ->get();
+
+        $avgLos = null;
+        if ($completedVisits->isNotEmpty()) {
+            $avgLos = round($completedVisits->avg(function (Visit $visit) {
+                return $visit->checked_in_at->diffInMinutes($visit->completed_at);
+            }), 1);
+        }
+
+        $serviceLabels = collect($this->shell->provisionedServices($organization, 'pediatrics'))
+            ->pluck('label')
+            ->filter()
+            ->values()
+            ->all();
+
+        $revenueByService = BillLineItem::query()
+            ->where('owner_ref', $ownerRef)
+            ->where('source_type', 'specialty_service')
+            ->whereIn('description', $serviceLabels ?: ['__none__'])
+            ->whereBetween('created_at', [$rangeFrom, $rangeTo])
+            ->whereHas('bill', function ($q) use ($organization, $visitIds) {
+                $q->where('organization_id', $organization->id)
+                    ->whereIn('visit_id', $visitIds->isEmpty() ? [0] : $visitIds)
+                    ->whereNotIn('status', [Bill::STATUS_VOID]);
+            })
+            ->selectRaw('description, count(*) as total, sum(total_minor) as amount_minor')
+            ->groupBy('description')
+            ->orderByDesc('amount_minor')
+            ->get();
+
+        return [
+            'arrivals_today' => $arrivalsToday,
+            'completed_today' => $completedToday,
+            'growth_concern_open' => $growthConcernOpen,
+            'diagnosis_breakdown' => $diagnosisBreakdown,
+            'treatment_breakdown' => $treatmentBreakdown,
+            'avg_los_minutes' => $avgLos,
+            'revenue_by_service' => $revenueByService,
+            'from' => $rangeFrom->toDateString(),
+            'to' => $rangeTo->toDateString(),
+        ];
+    }
+}

app/Services/Care/Pediatrics/PediatricsWorkflowService.php

@@ -0,0 +1,104 @@
+<?php
+
+namespace App\Services\Care\Pediatrics;
+
+/**
+ * Map pediatrics clinical progress onto visit stages.
+ */
+class PediatricsWorkflowService
+{
+    public const STAGE_CHECK_IN = 'check_in';
+
+    public const STAGE_HISTORY = 'history';
+
+    public const STAGE_EXAM = 'exam';
+
+    public const STAGE_INVESTIGATION = 'investigation';
+
+    public const STAGE_PLAN = 'plan';
+
+    public const STAGE_TREATMENT = 'treatment';
+
+    public const STAGE_COMPLETED = 'completed';
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromHistory(array $payload): string
+    {
+        $history = trim((string) ($payload['history'] ?? ''));
+        if ($history !== '') {
+            return self::STAGE_HISTORY;
+        }
+
+        return self::STAGE_CHECK_IN;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromExam(array $payload): string
+    {
+        if (! empty($payload['examination']) || ! empty($payload['chief_complaint'])) {
+            return self::STAGE_EXAM;
+        }
+
+        return self::STAGE_HISTORY;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromInvestigation(array $payload): string
+    {
+        $findings = trim((string) ($payload['findings'] ?? ''));
+        if ($findings !== '') {
+            return self::STAGE_INVESTIGATION;
+        }
+
+        return self::STAGE_EXAM;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromPlan(array $payload): string
+    {
+        if (! empty($payload['treatment_planned'])) {
+            return self::STAGE_TREATMENT;
+        }
+
+        $plan = trim((string) ($payload['plan'] ?? ''));
+        if ($plan !== '') {
+            return self::STAGE_PLAN;
+        }
+
+        return self::STAGE_INVESTIGATION;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function shouldCompleteVisit(array $payload): bool
+    {
+        $outcome = strtolower((string) ($payload['outcome'] ?? ''));
+
+        return str_contains($outcome, 'completed');
+    }
+
+    /**
+     * @return array<string, array{next: string, label: string}>
+     */
+    public function stageFlow(): array
+    {
+        return [
+            self::STAGE_CHECK_IN => ['next' => self::STAGE_HISTORY, 'label' => 'Start history'],
+            self::STAGE_HISTORY => ['next' => self::STAGE_EXAM, 'label' => 'Move to exam / growth'],
+            self::STAGE_EXAM => ['next' => self::STAGE_INVESTIGATION, 'label' => 'Move to investigations'],
+            self::STAGE_INVESTIGATION => ['next' => self::STAGE_PLAN, 'label' => 'Move to diagnosis & plan'],
+            self::STAGE_PLAN => ['next' => self::STAGE_TREATMENT, 'label' => 'Move to treatment'],
+            self::STAGE_TREATMENT => ['next' => self::STAGE_COMPLETED, 'label' => 'Complete visit'],
+            self::STAGE_COMPLETED => ['next' => self::STAGE_COMPLETED, 'label' => 'Completed'],
+        ];
+    }
+}

app/Services/Care/SpecialtyClinicalRecordService.php

@@ -419,6 +419,58 @@ class SpecialtyClinicalRecordService
             }
         }
 
+        if ($moduleKey === 'pediatrics' && $recordType === 'pediatric_exam') {
+            $concern = (string) ($payload['growth_concern'] ?? '');
+            if ($concern !== '' && $concern !== 'None') {
+                $alerts[] = [
+                    'code' => 'ped.growth_concern',
+                    'severity' => in_array($concern, ['Wasting', 'Underweight'], true) ? 'critical' : 'warning',
+                    'message' => 'Growth concern: '.$concern.'.',
+                ];
+            }
+            $temp = (float) ($payload['temperature_c'] ?? 0);
+            if ($temp >= 39.0) {
+                $alerts[] = [
+                    'code' => 'ped.fever_high',
+                    'severity' => 'critical',
+                    'message' => 'High fever recorded ('.$temp.'°C).',
+                ];
+            } elseif ($temp >= 38.0) {
+                $alerts[] = [
+                    'code' => 'ped.fever',
+                    'severity' => 'warning',
+                    'message' => 'Fever recorded ('.$temp.'°C).',
+                ];
+            }
+        }
+
+        if ($moduleKey === 'orthopedics' && $recordType === 'ortho_exam') {
+            $nv = strtolower((string) ($payload['neurovascular'] ?? ''));
+            if (str_contains($nv, 'vascular compromise')) {
+                $alerts[] = [
+                    'code' => 'ort.nv_vascular',
+                    'severity' => 'critical',
+                    'message' => 'Vascular compromise on ortho exam.',
+                ];
+            } elseif (str_contains($nv, 'deficit')) {
+                $alerts[] = [
+                    'code' => 'ort.nv_deficit',
+                    'severity' => 'warning',
+                    'message' => 'Neurovascular deficit recorded.',
+                ];
+            }
+        }
+
+        if ($moduleKey === 'ent' && $recordType === 'ent_exam') {
+            if (! empty($payload['airway_concern'])) {
+                $alerts[] = [
+                    'code' => 'ent.airway_concern',
+                    'severity' => 'critical',
+                    'message' => 'Airway concern flagged on ENT exam.',
+                ];
+            }
+        }
+
         if ($moduleKey === 'psychiatry' && $recordType === 'risk_assessment') {
             $level = strtolower((string) ($payload['overall_risk'] ?? ''));
             if (str_contains($level, 'imminent')) {

app/Services/Care/SpecialtyShellService.php

@@ -17,6 +17,9 @@ use App\Services\Care\Maternity\MaternityWorkflowService;
 use App\Services\Care\Radiology\RadiologyWorkflowService;
 use App\Services\Care\Cardiology\CardiologyWorkflowService;
 use App\Services\Care\Psychiatry\PsychiatryWorkflowService;
+use App\Services\Care\Pediatrics\PediatricsWorkflowService;
+use App\Services\Care\Orthopedics\OrthopedicsWorkflowService;
+use App\Services\Care\Ent\EntWorkflowService;
 use Illuminate\Support\Collection;
 
 /**
@@ -66,6 +69,9 @@ class SpecialtyShellService
             'radiology' => 'care.specialty.radiology.stage',
             'cardiology' => 'care.specialty.cardiology.stage',
             'psychiatry' => 'care.specialty.psychiatry.stage',
+            'pediatrics' => 'care.specialty.pediatrics.stage',
+            'orthopedics' => 'care.specialty.orthopedics.stage',
+            'ent' => 'care.specialty.ent.stage',
             default => null,
         };
     }
@@ -86,6 +92,9 @@ class SpecialtyShellService
             'radiology' => app(RadiologyWorkflowService::class)->stageFlow(),
             'cardiology' => app(CardiologyWorkflowService::class)->stageFlow(),
             'psychiatry' => app(PsychiatryWorkflowService::class)->stageFlow(),
+            'pediatrics' => app(PediatricsWorkflowService::class)->stageFlow(),
+            'orthopedics' => app(OrthopedicsWorkflowService::class)->stageFlow(),
+            'ent' => app(EntWorkflowService::class)->stageFlow(),
             'dentistry' => [
                 'waiting' => ['next' => 'chair', 'label' => 'Seat at chair'],
                 'chair' => ['next' => 'procedure', 'label' => 'Start procedure'],
@@ -385,7 +394,7 @@ class SpecialtyShellService
         ) {
             $code = (string) ($stage['code'] ?? '');
 
-            if (in_array($moduleKey, ['dentistry', 'emergency', 'blood_bank', 'ophthalmology', 'physiotherapy', 'maternity', 'radiology', 'cardiology', 'psychiatry'], true) && $visitIds->isNotEmpty()) {
+            if (in_array($moduleKey, ['dentistry', 'emergency', 'blood_bank', 'ophthalmology', 'physiotherapy', 'maternity', 'radiology', 'cardiology', 'psychiatry', 'pediatrics', 'orthopedics', 'ent'], true) && $visitIds->isNotEmpty()) {
                 $count = Visit::owned($ownerRef)
                     ->where('organization_id', $organization->id)
                     ->whereIn('id', $visitIds)
@@ -421,6 +430,9 @@ class SpecialtyShellService
             'radiology' => $clinical->countOpenByType($organization, 'radiology', 'imaging_request', $branchScope),
             'cardiology' => $clinical->countOpenByType($organization, 'cardiology', 'cardiac_exam', $branchScope),
             'psychiatry' => $clinical->countOpenByType($organization, 'psychiatry', 'mental_status', $branchScope),
+            'pediatrics' => $clinical->countOpenByType($organization, 'pediatrics', 'pediatric_exam', $branchScope),
+            'orthopedics' => $clinical->countOpenByType($organization, 'orthopedics', 'ortho_exam', $branchScope),
+            'ent' => $clinical->countOpenByType($organization, 'ent', 'ent_exam', $branchScope),
             'dentistry' => \App\Models\DentalPlanItem::query()
                 ->whereHas('plan', function ($q) use ($organization, $ownerRef) {
                     $q->owned($ownerRef)

app/Services/Care/SpecialtyVisitStageService.php

@@ -144,6 +144,30 @@ class SpecialtyVisitStageService
                 : ($stages[1] ?? ($stages[0] ?? null));
         }
 
+        if ($moduleKey === 'pediatrics') {
+            $stages = $this->allowedStages($moduleKey);
+
+            return in_array(\App\Services\Care\Pediatrics\PediatricsWorkflowService::STAGE_HISTORY, $stages, true)
+                ? \App\Services\Care\Pediatrics\PediatricsWorkflowService::STAGE_HISTORY
+                : ($stages[1] ?? ($stages[0] ?? null));
+        }
+
+        if ($moduleKey === 'orthopedics') {
+            $stages = $this->allowedStages($moduleKey);
+
+            return in_array(\App\Services\Care\Orthopedics\OrthopedicsWorkflowService::STAGE_HISTORY, $stages, true)
+                ? \App\Services\Care\Orthopedics\OrthopedicsWorkflowService::STAGE_HISTORY
+                : ($stages[1] ?? ($stages[0] ?? null));
+        }
+
+        if ($moduleKey === 'ent') {
+            $stages = $this->allowedStages($moduleKey);
+
+            return in_array(\App\Services\Care\Ent\EntWorkflowService::STAGE_HISTORY, $stages, true)
+                ? \App\Services\Care\Ent\EntWorkflowService::STAGE_HISTORY
+                : ($stages[1] ?? ($stages[0] ?? null));
+        }
+
         $stages = $this->allowedStages($moduleKey);
         foreach (['chair', 'in_care', 'exam', 'assessment', 'treatment'] as $preferred) {
             if (in_array($preferred, $stages, true)) {

config/care_specialty_clinical.php

@@ -66,16 +66,25 @@ return [
             'followup' => 'psych_followup',
         ],
         'pediatrics' => [
-            'exam' => 'pediatric_exam',
+            'history' => 'ped_history',
-            'clinical_notes' => 'clinical_note',
+            'growth' => 'pediatric_exam',
+            'investigations' => 'ped_investigation',
+            'plan' => 'ped_plan',
+            'treatment' => 'ped_treatment',
         ],
         'orthopedics' => [
+            'history' => 'ortho_history',
             'exam' => 'ortho_exam',
-            'clinical_notes' => 'clinical_note',
+            'imaging' => 'ortho_imaging',
+            'plan' => 'ortho_plan',
+            'procedure' => 'ortho_procedure',
         ],
         'ent' => [
+            'history' => 'ent_history',
             'exam' => 'ent_exam',
-            'clinical_notes' => 'clinical_note',
+            'investigations' => 'ent_investigation',
+            'plan' => 'ent_plan',
+            'procedure' => 'ent_procedure',
         ],
         'oncology' => [
             'review' => 'oncology_review',
@@ -480,42 +489,103 @@ return [
             ],
         ],
         'pediatrics' => [
+            'ped_history' => [
+                ['name' => 'history', 'label' => 'History of present illness', 'type' => 'textarea', 'required' => true, 'rows' => 4],
+                ['name' => 'birth_history', 'label' => 'Birth / neonatal history', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'past_medical', 'label' => 'Past medical history', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'medications', 'label' => 'Medications', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'allergies', 'label' => 'Allergies', 'type' => 'text'],
+                ['name' => 'feeding', 'label' => 'Feeding / nutrition', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'social', 'label' => 'Social / family context', 'type' => 'textarea', 'rows' => 2],
+            ],
             'pediatric_exam' => [
                 ['name' => 'chief_complaint', 'label' => 'Chief complaint', 'type' => 'text', 'required' => true],
                 ['name' => 'age_months', 'label' => 'Age (months)', 'type' => 'number'],
                 ['name' => 'weight_kg', 'label' => 'Weight (kg)', 'type' => 'number'],
                 ['name' => 'height_cm', 'label' => 'Height / length (cm)', 'type' => 'number'],
                 ['name' => 'head_circumference_cm', 'label' => 'Head circumference (cm)', 'type' => 'number'],
+                ['name' => 'temperature_c', 'label' => 'Temperature (°C)', 'type' => 'number'],
+                ['name' => 'growth_concern', 'label' => 'Growth concern', 'type' => 'select', 'options' => ['None', 'Underweight', 'Stunting', 'Wasting', 'Overweight']],
                 ['name' => 'developmental', 'label' => 'Developmental notes', 'type' => 'textarea', 'rows' => 2],
                 ['name' => 'immunization_status', 'label' => 'Immunization status', 'type' => 'text'],
                 ['name' => 'examination', 'label' => 'Examination', 'type' => 'textarea', 'required' => true, 'rows' => 3],
             ],
-            'clinical_note' => [
+            'ped_investigation' => [
-                ['name' => 'history', 'label' => 'History of present illness', 'type' => 'textarea', 'required' => true, 'rows' => 4],
+                ['name' => 'investigation', 'label' => 'Investigation', 'type' => 'text', 'required' => true],
-                ['name' => 'examination', 'label' => 'Examination', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'findings', 'label' => 'Findings', 'type' => 'textarea', 'required' => true, 'rows' => 3],
-                ['name' => 'working_diagnosis', 'label' => 'Working diagnosis', 'type' => 'text'],
+                ['name' => 'impression', 'label' => 'Impression', 'type' => 'textarea', 'rows' => 2],
-                ['name' => 'plan', 'label' => 'Plan', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'notes', 'label' => 'Notes', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'ped_plan' => [
+                ['name' => 'diagnosis', 'label' => 'Diagnosis', 'type' => 'text', 'required' => true],
+                ['name' => 'plan', 'label' => 'Plan', 'type' => 'textarea', 'required' => true, 'rows' => 3],
+                ['name' => 'medications', 'label' => 'Medications', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'treatment_planned', 'label' => 'Treatment / immunization planned', 'type' => 'boolean'],
+                ['name' => 'follow_up', 'label' => 'Follow-up', 'type' => 'text'],
+                ['name' => 'advice', 'label' => 'Caregiver advice', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'ped_treatment' => [
+                ['name' => 'treatment', 'label' => 'Treatment / immunization', 'type' => 'text', 'required' => true],
+                ['name' => 'vaccine_or_procedure', 'label' => 'Vaccine / procedure details', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'site_route', 'label' => 'Site / route', 'type' => 'text'],
+                ['name' => 'outcome', 'label' => 'Outcome', 'type' => 'select', 'required' => true, 'options' => ['Completed uneventfully', 'Completed with complications', 'Deferred', 'Aborted']],
+                ['name' => 'adverse_events', 'label' => 'Adverse events', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'post_treatment_plan', 'label' => 'Post-treatment plan', 'type' => 'textarea', 'rows' => 2],
             ],
         ],
         'orthopedics' => [
+            'ortho_history' => [
+                ['name' => 'history', 'label' => 'History of present illness', 'type' => 'textarea', 'required' => true, 'rows' => 4],
+                ['name' => 'mechanism', 'label' => 'Mechanism of injury', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'past_ortho', 'label' => 'Past orthopedic history', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'medications', 'label' => 'Medications', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'allergies', 'label' => 'Allergies', 'type' => 'text'],
+                ['name' => 'comorbidities', 'label' => 'Comorbidities', 'type' => 'textarea', 'rows' => 2],
+            ],
             'ortho_exam' => [
                 ['name' => 'chief_complaint', 'label' => 'Chief complaint', 'type' => 'text', 'required' => true],
                 ['name' => 'side', 'label' => 'Side', 'type' => 'select', 'options' => ['Left', 'Right', 'Bilateral', 'N/A']],
                 ['name' => 'region', 'label' => 'Region / joint', 'type' => 'text', 'required' => true],
-                ['name' => 'mechanism', 'label' => 'Mechanism of injury', 'type' => 'textarea', 'rows' => 2],
                 ['name' => 'rom', 'label' => 'Range of motion', 'type' => 'textarea', 'rows' => 2],
-                ['name' => 'neurovascular', 'label' => 'Neurovascular status', 'type' => 'text'],
+                ['name' => 'neurovascular', 'label' => 'Neurovascular status', 'type' => 'select', 'options' => ['Intact', 'Sensory deficit', 'Motor deficit', 'Vascular compromise', 'Not assessed']],
-                ['name' => 'imaging', 'label' => 'Imaging findings', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'swelling', 'label' => 'Swelling / deformity', 'type' => 'text'],
+                ['name' => 'exam_findings', 'label' => 'Examination findings', 'type' => 'textarea', 'rows' => 3],
                 ['name' => 'fracture_classification', 'label' => 'Fracture / injury classification', 'type' => 'text'],
             ],
-            'clinical_note' => [
+            'ortho_imaging' => [
-                ['name' => 'history', 'label' => 'History of present illness', 'type' => 'textarea', 'required' => true, 'rows' => 4],
+                ['name' => 'modality', 'label' => 'Modality', 'type' => 'select', 'required' => true, 'options' => ['X-ray', 'CT', 'MRI', 'Ultrasound', 'Other']],
-                ['name' => 'examination', 'label' => 'Examination', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'region', 'label' => 'Region imaged', 'type' => 'text', 'required' => true],
-                ['name' => 'working_diagnosis', 'label' => 'Working diagnosis', 'type' => 'text'],
+                ['name' => 'findings', 'label' => 'Findings', 'type' => 'textarea', 'required' => true, 'rows' => 3],
-                ['name' => 'plan', 'label' => 'Plan', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'impression', 'label' => 'Impression', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'notes', 'label' => 'Notes', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'ortho_plan' => [
+                ['name' => 'diagnosis', 'label' => 'Diagnosis', 'type' => 'text', 'required' => true],
+                ['name' => 'plan', 'label' => 'Plan', 'type' => 'textarea', 'required' => true, 'rows' => 3],
+                ['name' => 'weight_bearing', 'label' => 'Weight-bearing status', 'type' => 'text'],
+                ['name' => 'procedure_planned', 'label' => 'Procedure / cast planned', 'type' => 'boolean'],
+                ['name' => 'follow_up', 'label' => 'Follow-up', 'type' => 'text'],
+                ['name' => 'advice', 'label' => 'Patient advice', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'ortho_procedure' => [
+                ['name' => 'procedure', 'label' => 'Procedure / cast', 'type' => 'text', 'required' => true],
+                ['name' => 'indication', 'label' => 'Indication', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'technique', 'label' => 'Technique / materials', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'outcome', 'label' => 'Outcome', 'type' => 'select', 'required' => true, 'options' => ['Completed uneventfully', 'Completed with complications', 'Deferred', 'Aborted']],
+                ['name' => 'post_procedure_plan', 'label' => 'Post-procedure plan', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'notes', 'label' => 'Notes', 'type' => 'textarea', 'rows' => 2],
             ],
         ],
         'ent' => [
+            'ent_history' => [
+                ['name' => 'history', 'label' => 'History of present illness', 'type' => 'textarea', 'required' => true, 'rows' => 4],
+                ['name' => 'ear_symptoms', 'label' => 'Ear symptoms', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'nose_symptoms', 'label' => 'Nose / sinus symptoms', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'throat_symptoms', 'label' => 'Throat / voice symptoms', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'past_ent', 'label' => 'Past ENT history', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'medications', 'label' => 'Medications', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'allergies', 'label' => 'Allergies', 'type' => 'text'],
+            ],
             'ent_exam' => [
                 ['name' => 'chief_complaint', 'label' => 'Chief complaint', 'type' => 'text', 'required' => true],
                 ['name' => 'ear_findings', 'label' => 'Ear findings', 'type' => 'textarea', 'rows' => 2],
@@ -523,12 +593,30 @@ return [
                 ['name' => 'throat_findings', 'label' => 'Throat / larynx findings', 'type' => 'textarea', 'rows' => 2],
                 ['name' => 'hearing', 'label' => 'Hearing assessment', 'type' => 'text'],
                 ['name' => 'neck', 'label' => 'Neck examination', 'type' => 'text'],
+                ['name' => 'airway_concern', 'label' => 'Airway concern', 'type' => 'boolean'],
+                ['name' => 'exam_summary', 'label' => 'Exam summary', 'type' => 'textarea', 'rows' => 2],
             ],
-            'clinical_note' => [
+            'ent_investigation' => [
-                ['name' => 'history', 'label' => 'History of present illness', 'type' => 'textarea', 'required' => true, 'rows' => 4],
+                ['name' => 'investigation', 'label' => 'Investigation', 'type' => 'text', 'required' => true],
-                ['name' => 'examination', 'label' => 'Examination', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'findings', 'label' => 'Findings', 'type' => 'textarea', 'required' => true, 'rows' => 3],
-                ['name' => 'working_diagnosis', 'label' => 'Working diagnosis', 'type' => 'text'],
+                ['name' => 'impression', 'label' => 'Impression', 'type' => 'textarea', 'rows' => 2],
-                ['name' => 'plan', 'label' => 'Plan', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'notes', 'label' => 'Notes', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'ent_plan' => [
+                ['name' => 'diagnosis', 'label' => 'Diagnosis', 'type' => 'text', 'required' => true],
+                ['name' => 'plan', 'label' => 'Plan', 'type' => 'textarea', 'required' => true, 'rows' => 3],
+                ['name' => 'medications', 'label' => 'Medications', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'procedure_planned', 'label' => 'Procedure planned', 'type' => 'boolean'],
+                ['name' => 'follow_up', 'label' => 'Follow-up', 'type' => 'text'],
+                ['name' => 'advice', 'label' => 'Patient advice', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'ent_procedure' => [
+                ['name' => 'procedure', 'label' => 'Procedure', 'type' => 'text', 'required' => true],
+                ['name' => 'indication', 'label' => 'Indication', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'technique', 'label' => 'Technique', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'outcome', 'label' => 'Outcome', 'type' => 'select', 'required' => true, 'options' => ['Completed uneventfully', 'Completed with complications', 'Deferred', 'Aborted']],
+                ['name' => 'post_procedure_plan', 'label' => 'Post-procedure plan', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'notes', 'label' => 'Notes', 'type' => 'textarea', 'rows' => 2],
             ],
         ],
         'oncology' => [

config/care_specialty_modules.php

@@ -166,6 +166,7 @@ return [
         'queue_keywords' => ['pedia', 'paedia', 'child', 'infant'],
         'access' => 'general',
         'roles' => ['doctor', 'nurse', 'receptionist'],
+        'specialist_keywords' => ['pedia', 'paedia', 'pediatric', 'paediatric', 'child', 'infant'],
     ],
     'orthopedics' => [
         'label' => 'Orthopedics',
@@ -179,7 +180,7 @@ return [
         'queue_keywords' => ['ortho', 'fracture', 'bone', 'joint'],
         'access' => 'restricted',
         'roles' => ['doctor'],
-        'support_roles' => [],
+        'support_roles' => ['nurse'],
         'view_roles' => ['doctor', 'nurse'],
         'refer_roles' => ['doctor', 'nurse'],
         'specialist_keywords' => ['ortho', 'orthopedic', 'orthopaedic', 'fracture'],
@@ -196,7 +197,7 @@ return [
         'queue_keywords' => ['ent', 'ear', 'nose', 'throat', 'otolaryng'],
         'access' => 'restricted',
         'roles' => ['doctor'],
-        'support_roles' => [],
+        'support_roles' => ['nurse'],
         'view_roles' => ['doctor', 'nurse'],
         'refer_roles' => ['doctor', 'nurse'],
         'specialist_keywords' => ['ent', 'otolaryng', 'ear', 'nose', 'throat'],

config/care_specialty_shell.php

@@ -402,60 +402,114 @@ return [
         ],
         'pediatrics' => [
             'stages' => [
-                ['code' => 'waiting', 'label' => 'Waiting', 'queue_point' => 'waiting'],
+                ['code' => 'check_in', 'label' => 'Check-in', 'queue_point' => 'waiting'],
-                ['code' => 'exam', 'label' => 'Pediatric exam', 'queue_point' => 'chair'],
+                ['code' => 'history', 'label' => 'History', 'queue_point' => 'waiting'],
+                ['code' => 'exam', 'label' => 'Exam / growth', 'queue_point' => 'chair'],
+                ['code' => 'investigation', 'label' => 'Investigations', 'queue_point' => 'chair'],
+                ['code' => 'plan', 'label' => 'Diagnosis & plan', 'queue_point' => 'chair'],
+                ['code' => 'treatment', 'label' => 'Treatment / immunization', 'queue_point' => 'chair'],
                 ['code' => 'completed', 'label' => 'Completed', 'queue_point' => null],
             ],
             'services' => [
                 ['code' => 'ped.consult', 'label' => 'Pediatric consultation', 'amount_minor' => 5000, 'type' => 'consultation'],
+                ['code' => 'ped.growth', 'label' => 'Growth assessment', 'amount_minor' => 3000, 'type' => 'consultation'],
+                ['code' => 'ped.immunization', 'label' => 'Immunization visit', 'amount_minor' => 4000, 'type' => 'procedure'],
+                ['code' => 'ped.procedure', 'label' => 'Pediatric procedure', 'amount_minor' => 8000, 'type' => 'procedure'],
             ],
             'workspace_tabs' => [
                 'overview' => 'Overview',
-                'exam' => 'Pediatric exam',
+                'history' => 'History',
-                'clinical_notes' => 'Clinical notes',
+                'growth' => 'Growth / exam',
+                'investigations' => 'Investigations',
+                'plan' => 'Diagnosis & plan',
+                'treatment' => 'Treatment',
                 'orders' => 'Orders',
                 'billing' => 'Billing',
                 'documents' => 'Documents',
             ],
+            'stage_tabs' => [
+                'check_in' => 'overview',
+                'history' => 'history',
+                'exam' => 'growth',
+                'investigation' => 'investigations',
+                'plan' => 'plan',
+                'treatment' => 'treatment',
+                'completed' => 'overview',
+            ],
         ],
         'orthopedics' => [
             'stages' => [
-                ['code' => 'waiting', 'label' => 'Waiting', 'queue_point' => 'waiting'],
+                ['code' => 'check_in', 'label' => 'Check-in', 'queue_point' => 'waiting'],
-                ['code' => 'exam', 'label' => 'Ortho exam', 'queue_point' => 'chair'],
+                ['code' => 'history', 'label' => 'History', 'queue_point' => 'waiting'],
-                ['code' => 'procedure', 'label' => 'Procedure / casting', 'queue_point' => 'chair'],
+                ['code' => 'exam', 'label' => 'Exam', 'queue_point' => 'chair'],
+                ['code' => 'imaging', 'label' => 'Imaging', 'queue_point' => 'chair'],
+                ['code' => 'plan', 'label' => 'Diagnosis & plan', 'queue_point' => 'chair'],
+                ['code' => 'procedure', 'label' => 'Procedure / cast', 'queue_point' => 'chair'],
                 ['code' => 'completed', 'label' => 'Completed', 'queue_point' => null],
             ],
             'services' => [
                 ['code' => 'ort.consult', 'label' => 'Orthopedic consultation', 'amount_minor' => 6000, 'type' => 'consultation'],
+                ['code' => 'ort.xray', 'label' => 'Ortho imaging review', 'amount_minor' => 5000, 'type' => 'imaging'],
                 ['code' => 'ort.cast', 'label' => 'Casting / splinting', 'amount_minor' => 10000, 'type' => 'procedure'],
+                ['code' => 'ort.procedure', 'label' => 'Orthopedic procedure', 'amount_minor' => 25000, 'type' => 'procedure'],
             ],
             'workspace_tabs' => [
                 'overview' => 'Overview',
-                'exam' => 'Ortho exam',
+                'history' => 'History',
-                'clinical_notes' => 'Clinical notes',
+                'exam' => 'Exam',
+                'imaging' => 'Imaging',
+                'plan' => 'Diagnosis & plan',
+                'procedure' => 'Procedure',
                 'orders' => 'Orders',
                 'billing' => 'Billing',
                 'documents' => 'Documents',
             ],
+            'stage_tabs' => [
+                'check_in' => 'overview',
+                'history' => 'history',
+                'exam' => 'exam',
+                'imaging' => 'imaging',
+                'plan' => 'plan',
+                'procedure' => 'procedure',
+                'completed' => 'overview',
+            ],
         ],
         'ent' => [
             'stages' => [
-                ['code' => 'waiting', 'label' => 'Waiting', 'queue_point' => 'waiting'],
+                ['code' => 'check_in', 'label' => 'Check-in', 'queue_point' => 'waiting'],
-                ['code' => 'exam', 'label' => 'ENT exam', 'queue_point' => 'chair'],
+                ['code' => 'history', 'label' => 'History', 'queue_point' => 'waiting'],
+                ['code' => 'exam', 'label' => 'Exam', 'queue_point' => 'chair'],
+                ['code' => 'investigation', 'label' => 'Investigations', 'queue_point' => 'chair'],
+                ['code' => 'plan', 'label' => 'Diagnosis & plan', 'queue_point' => 'chair'],
+                ['code' => 'procedure', 'label' => 'Procedure', 'queue_point' => 'chair'],
                 ['code' => 'completed', 'label' => 'Completed', 'queue_point' => null],
             ],
             'services' => [
                 ['code' => 'ent.consult', 'label' => 'ENT consultation', 'amount_minor' => 6000, 'type' => 'consultation'],
+                ['code' => 'ent.audiology', 'label' => 'Hearing assessment', 'amount_minor' => 5000, 'type' => 'procedure'],
                 ['code' => 'ent.procedure', 'label' => 'ENT procedure', 'amount_minor' => 12000, 'type' => 'procedure'],
+                ['code' => 'ent.endoscopy', 'label' => 'Nasal / laryngeal endoscopy', 'amount_minor' => 15000, 'type' => 'procedure'],
             ],
             'workspace_tabs' => [
                 'overview' => 'Overview',
-                'exam' => 'ENT exam',
+                'history' => 'History',
-                'clinical_notes' => 'Clinical notes',
+                'exam' => 'Exam',
+                'investigations' => 'Investigations',
+                'plan' => 'Diagnosis & plan',
+                'procedure' => 'Procedure',
                 'orders' => 'Orders',
                 'billing' => 'Billing',
                 'documents' => 'Documents',
             ],
+            'stage_tabs' => [
+                'check_in' => 'overview',
+                'history' => 'history',
+                'exam' => 'exam',
+                'investigation' => 'investigations',
+                'plan' => 'plan',
+                'procedure' => 'procedure',
+                'completed' => 'overview',
+            ],
         ],
         'oncology' => [
             'stages' => [

resources/views/care/specialty/ent/print.blade.php

@@ -0,0 +1,91 @@
+<!DOCTYPE html>
+<html lang="en">
+<head>
+    <meta charset="utf-8">
+    <title>ENT summary · {{ $patient->fullName() }}</title>
+    <style>
+        body { font-family: system-ui, sans-serif; color: #0f172a; margin: 2rem; }
+        h1 { font-size: 1.25rem; margin: 0 0 .25rem; }
+        h2 { font-size: .95rem; margin: 1.25rem 0 .5rem; border-bottom: 1px solid #e2e8f0; padding-bottom: .25rem; }
+        .meta { color: #64748b; font-size: .875rem; }
+        dl { display: grid; grid-template-columns: 10rem 1fr; gap: .35rem .75rem; font-size: .875rem; }
+        dt { color: #64748b; }
+        dd { margin: 0; font-weight: 500; }
+        @media print { .no-print { display: none; } }
+    </style>
+</head>
+<body>
+    <p class="no-print"><a href="{{ route('care.specialty.workspace', ['module' => 'ent', 'visit' => $visit]) }}">Back</a></p>
+
+    <h1>{{ $patient->fullName() }}</h1>
+    <p class="meta">
+        {{ $patient->patient_number }}
+        · Visit #{{ $visit->id }}
+        · Stage {{ $visit->specialty_stage ?? '—' }}
+        · {{ $visit->checked_in_at?->format('d M Y H:i') ?? '—' }}
+    </p>
+
+    <h2>History</h2>
+    @if ($history)
+        <dl>
+            <dt>HPI</dt><dd>{{ $history->payload['history'] ?? '—' }}</dd>
+            <dt>Ear</dt><dd>{{ $history->payload['ear_symptoms'] ?? '—' }}</dd>
+            <dt>Nose</dt><dd>{{ $history->payload['nose_symptoms'] ?? '—' }}</dd>
+            <dt>Throat</dt><dd>{{ $history->payload['throat_symptoms'] ?? '—' }}</dd>
+            <dt>Medications</dt><dd>{{ $history->payload['medications'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No history recorded.</p>
+    @endif
+
+    <h2>Exam</h2>
+    @if ($exam)
+        <dl>
+            <dt>Complaint</dt><dd>{{ $exam->payload['chief_complaint'] ?? '—' }}</dd>
+            <dt>Ear</dt><dd>{{ $exam->payload['ear_findings'] ?? '—' }}</dd>
+            <dt>Nose</dt><dd>{{ $exam->payload['nose_findings'] ?? '—' }}</dd>
+            <dt>Throat</dt><dd>{{ $exam->payload['throat_findings'] ?? '—' }}</dd>
+            <dt>Hearing</dt><dd>{{ $exam->payload['hearing'] ?? '—' }}</dd>
+            <dt>Airway</dt><dd>{{ ! empty($exam->payload['airway_concern']) ? 'Concern flagged' : 'No concern' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No exam recorded.</p>
+    @endif
+
+    <h2>Investigations</h2>
+    @if ($investigation)
+        <dl>
+            <dt>Investigation</dt><dd>{{ $investigation->payload['investigation'] ?? '—' }}</dd>
+            <dt>Findings</dt><dd>{{ $investigation->payload['findings'] ?? '—' }}</dd>
+            <dt>Impression</dt><dd>{{ $investigation->payload['impression'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No investigation recorded.</p>
+    @endif
+
+    <h2>Diagnosis & plan</h2>
+    @if ($plan)
+        <dl>
+            <dt>Diagnosis</dt><dd>{{ $plan->payload['diagnosis'] ?? '—' }}</dd>
+            <dt>Plan</dt><dd>{{ $plan->payload['plan'] ?? '—' }}</dd>
+            <dt>Medications</dt><dd>{{ $plan->payload['medications'] ?? '—' }}</dd>
+            <dt>Follow-up</dt><dd>{{ $plan->payload['follow_up'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No plan recorded.</p>
+    @endif
+
+    <h2>Procedure</h2>
+    @if ($procedure)
+        <dl>
+            <dt>Procedure</dt><dd>{{ $procedure->payload['procedure'] ?? '—' }}</dd>
+            <dt>Outcome</dt><dd>{{ $procedure->payload['outcome'] ?? '—' }}</dd>
+            <dt>Plan</dt><dd>{{ $procedure->payload['post_procedure_plan'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No procedure recorded.</p>
+    @endif
+
+    <script>window.print();</script>
+</body>
+</html>

resources/views/care/specialty/ent/reports.blade.php

@@ -0,0 +1,88 @@
+<x-app-layout title="ENT reports">
+    <div class="space-y-6">
+        <div class="flex flex-wrap items-center justify-between gap-3">
+            <div>
+                <h1 class="text-xl font-semibold text-slate-900">ENT reports</h1>
+                <p class="mt-1 text-sm text-slate-500">Arrivals, airway concerns, diagnoses, procedures, length of stay, and ENT revenue.</p>
+            </div>
+            <a href="{{ route('care.specialty.show', 'ent') }}" class="text-sm font-medium text-indigo-600">← Specialty home</a>
+        </div>
+
+        <form method="GET" class="flex flex-wrap items-end gap-3 rounded-2xl border border-slate-200 bg-white p-4">
+            <div>
+                <label class="block text-xs font-medium text-slate-600">From</label>
+                <input type="date" name="from" value="{{ $report['from'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">To</label>
+                <input type="date" name="to" value="{{ $report['to'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <button type="submit" class="rounded-xl bg-indigo-600 px-4 py-2 text-sm font-semibold text-white">Apply</button>
+        </form>
+
+        <div class="grid gap-4 sm:grid-cols-4">
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Arrivals today</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['arrivals_today']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Completed today</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['completed_today']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Airway concern open</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-rose-700">{{ number_format($report['airway_open']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Avg LOS (range)</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">
+                    {{ $report['avg_los_minutes'] !== null ? $report['avg_los_minutes'].' min' : '—' }}
+                </p>
+            </div>
+        </div>
+
+        <div class="grid gap-4 lg:grid-cols-2">
+            <section class="rounded-2xl border border-slate-200 bg-white p-5">
+                <h2 class="text-sm font-semibold text-slate-900">Diagnoses</h2>
+                <ul class="mt-3 space-y-2 text-sm">
+                    @forelse ($report['diagnosis_breakdown'] as $row)
+                        <li class="flex justify-between gap-3">
+                            <span>{{ $row['diagnosis'] }}</span>
+                            <span class="tabular-nums text-slate-600">{{ $row['total'] }}</span>
+                        </li>
+                    @empty
+                        <li class="text-slate-500">No care plans in range.</li>
+                    @endforelse
+                </ul>
+            </section>
+
+            <section class="rounded-2xl border border-slate-200 bg-white p-5">
+                <h2 class="text-sm font-semibold text-slate-900">Procedures</h2>
+                <ul class="mt-3 space-y-2 text-sm">
+                    @forelse ($report['procedure_breakdown'] as $row)
+                        <li class="flex justify-between gap-3">
+                            <span>{{ $row['procedure'] }}</span>
+                            <span class="tabular-nums text-slate-600">{{ $row['total'] }}</span>
+                        </li>
+                    @empty
+                        <li class="text-slate-500">No procedures in range.</li>
+                    @endforelse
+                </ul>
+            </section>
+        </div>
+
+        <section class="rounded-2xl border border-slate-200 bg-white p-5">
+            <h2 class="text-sm font-semibold text-slate-900">ENT service revenue</h2>
+            <ul class="mt-3 space-y-2 text-sm">
+                @forelse ($report['revenue_by_service'] as $row)
+                    <li class="flex justify-between gap-3">
+                        <span>{{ $row->description }} <span class="text-slate-400">×{{ $row->total }}</span></span>
+                        <span class="tabular-nums">{{ $currency }} {{ number_format($row->amount_minor / 100, 2) }}</span>
+                    </li>
+                @empty
+                    <li class="text-slate-500">No billed ENT services in range.</li>
+                @endforelse
+            </ul>
+        </section>
+    </div>
+</x-app-layout>

resources/views/care/specialty/ent/workspace-overview.blade.php

@@ -0,0 +1,71 @@
+@php
+    $hist = $entHistory?->payload ?? [];
+    $exam = $entExam?->payload ?? [];
+    $plan = $entPlan?->payload ?? [];
+@endphp
+
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">ENT overview</h3>
+            <p class="mt-0.5 text-xs text-slate-500">History, exam, investigations, and care plan for this episode.</p>
+        </div>
+        <div class="flex flex-wrap gap-3 text-sm">
+            <a href="{{ route('care.specialty.ent.print', $workspaceVisit) }}" target="_blank" class="font-medium text-indigo-600">Print summary</a>
+            <a href="{{ route('care.specialty.ent.reports') }}" class="font-medium text-indigo-600">ENT reports</a>
+        </div>
+    </div>
+
+    <div class="mt-4 grid gap-3 sm:grid-cols-3">
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Complaint</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $exam['chief_complaint'] ?? '—' }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ ! empty($exam['airway_concern']) ? 'Airway concern' : 'Airway OK' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Exam</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ \Illuminate\Support\Str::limit($exam['exam_summary'] ?? ($exam['throat_findings'] ?? '—'), 40) }}</p>
+            <p class="mt-1 text-xs text-slate-500">Hearing {{ $exam['hearing'] ?? '—' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Diagnosis / plan</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $plan['diagnosis'] ?? 'Not set' }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ $plan['follow_up'] ?? '—' }}</p>
+        </div>
+    </div>
+
+    <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+        <div>
+            <dt class="text-slate-500">History</dt>
+            <dd class="font-medium text-slate-900">{{ $hist['history'] ?? '—' }}</dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Plan</dt>
+            <dd class="font-medium text-slate-900">{{ $plan['plan'] ?? '—' }}</dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Queue</dt>
+            <dd class="font-medium text-slate-900">
+                {{ $workspaceVisit->appointment?->queue_ticket_number ?? '—' }}
+                @if ($workspaceVisit->appointment?->queue_ticket_status)
+                    <span class="text-slate-500">({{ $workspaceVisit->appointment->queue_ticket_status }})</span>
+                @endif
+            </dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Checked in</dt>
+            <dd class="font-medium text-slate-900">{{ $workspaceVisit->checked_in_at?->format('d M Y H:i') ?? '—' }}</dd>
+        </div>
+    </dl>
+
+    @if (! empty($clinicalAlerts))
+        <div class="mt-4 space-y-1.5 border-t border-slate-100 pt-4">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Alerts</p>
+            @foreach ($clinicalAlerts as $alert)
+                <p class="text-sm {{ ($alert['severity'] ?? '') === 'critical' ? 'text-rose-700' : 'text-amber-800' }}">
+                    {{ $alert['message'] ?? '' }}
+                </p>
+            @endforeach
+        </div>
+    @endif
+</section>

resources/views/care/specialty/ent/workspace-procedure.blade.php

@@ -0,0 +1,70 @@
+@php
+    $record = $entProcedure;
+    $payload = $record?->payload ?? [];
+    $canManage = $canManageClinical ?? $canConsult ?? false;
+@endphp
+
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Procedure</h3>
+            <p class="mt-0.5 text-xs text-slate-500">Completed procedures can close the ENT visit.</p>
+        </div>
+        <a href="{{ route('care.specialty.ent.print', $workspaceVisit) }}" target="_blank" class="text-sm font-medium text-indigo-600">Print summary</a>
+    </div>
+
+    @if ($canManage)
+        <form method="POST" action="{{ route('care.specialty.ent.procedure', $workspaceVisit) }}" class="mt-4 space-y-4">
+            @csrf
+            <input type="hidden" name="tab" value="procedure">
+            <div class="grid gap-3 sm:grid-cols-2">
+                @foreach ($clinicalFields ?? [] as $field)
+                    @php
+                        $name = $field['name'];
+                        $value = old('payload.'.$name, $payload[$name] ?? '');
+                        $type = $field['type'] ?? 'text';
+                    @endphp
+                    <div @class(['sm:col-span-2' => in_array($type, ['textarea'], true)])>
+                        <label class="block text-xs font-medium text-slate-600">
+                            {{ $field['label'] }}
+                            @if (! empty($field['required'])) <span class="text-rose-600">*</span> @endif
+                        </label>
+                        @if ($type === 'textarea')
+                            <textarea name="payload[{{ $name }}]" rows="{{ $field['rows'] ?? 3 }}" @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">{{ $value }}</textarea>
+                        @elseif ($type === 'select')
+                            <select name="payload[{{ $name }}]" @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                                <option value="">Select…</option>
+                                @foreach ($field['options'] ?? [] as $option)
+                                    <option value="{{ $option }}" @selected((string) $value === (string) $option)>{{ $option }}</option>
+                                @endforeach
+                            </select>
+                        @elseif ($type === 'boolean')
+                            <label class="mt-2 inline-flex items-center gap-2 text-sm text-slate-700">
+                                <input type="checkbox" name="payload[{{ $name }}]" value="1" @checked(old('payload.'.$name, ! empty($payload[$name])))>
+                                Yes
+                            </label>
+                        @else
+                            <input type="{{ $type === 'number' ? 'number' : 'text' }}" name="payload[{{ $name }}]" value="{{ $value }}"
+                                @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                        @endif
+                    </div>
+                @endforeach
+            </div>
+            <button type="submit" class="btn-primary">Save procedure</button>
+        </form>
+    @elseif ($record)
+        <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+            @foreach ($clinicalFields ?? [] as $field)
+                <div>
+                    <dt class="text-slate-500">{{ $field['label'] }}</dt>
+                    <dd class="font-medium text-slate-900">{{ $payload[$field['name']] ?? '—' }}</dd>
+                </div>
+            @endforeach
+        </dl>
+    @else
+        <p class="mt-4 text-sm text-slate-500">No procedure recorded yet.</p>
+    @endif
+</section>

resources/views/care/specialty/orthopedics/print.blade.php

@@ -0,0 +1,90 @@
+<!DOCTYPE html>
+<html lang="en">
+<head>
+    <meta charset="utf-8">
+    <title>Orthopedics summary · {{ $patient->fullName() }}</title>
+    <style>
+        body { font-family: system-ui, sans-serif; color: #0f172a; margin: 2rem; }
+        h1 { font-size: 1.25rem; margin: 0 0 .25rem; }
+        h2 { font-size: .95rem; margin: 1.25rem 0 .5rem; border-bottom: 1px solid #e2e8f0; padding-bottom: .25rem; }
+        .meta { color: #64748b; font-size: .875rem; }
+        dl { display: grid; grid-template-columns: 10rem 1fr; gap: .35rem .75rem; font-size: .875rem; }
+        dt { color: #64748b; }
+        dd { margin: 0; font-weight: 500; }
+        @media print { .no-print { display: none; } }
+    </style>
+</head>
+<body>
+    <p class="no-print"><a href="{{ route('care.specialty.workspace', ['module' => 'orthopedics', 'visit' => $visit]) }}">Back</a></p>
+
+    <h1>{{ $patient->fullName() }}</h1>
+    <p class="meta">
+        {{ $patient->patient_number }}
+        · Visit #{{ $visit->id }}
+        · Stage {{ $visit->specialty_stage ?? '—' }}
+        · {{ $visit->checked_in_at?->format('d M Y H:i') ?? '—' }}
+    </p>
+
+    <h2>History</h2>
+    @if ($history)
+        <dl>
+            <dt>HPI</dt><dd>{{ $history->payload['history'] ?? '—' }}</dd>
+            <dt>Mechanism</dt><dd>{{ $history->payload['mechanism'] ?? '—' }}</dd>
+            <dt>Past ortho</dt><dd>{{ $history->payload['past_ortho'] ?? '—' }}</dd>
+            <dt>Medications</dt><dd>{{ $history->payload['medications'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No history recorded.</p>
+    @endif
+
+    <h2>Exam</h2>
+    @if ($exam)
+        <dl>
+            <dt>Complaint</dt><dd>{{ $exam->payload['chief_complaint'] ?? '—' }}</dd>
+            <dt>Side / region</dt><dd>{{ $exam->payload['side'] ?? '—' }} · {{ $exam->payload['region'] ?? '—' }}</dd>
+            <dt>Neurovascular</dt><dd>{{ $exam->payload['neurovascular'] ?? '—' }}</dd>
+            <dt>Classification</dt><dd>{{ $exam->payload['fracture_classification'] ?? '—' }}</dd>
+            <dt>Findings</dt><dd>{{ $exam->payload['exam_findings'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No exam recorded.</p>
+    @endif
+
+    <h2>Imaging</h2>
+    @if ($imaging)
+        <dl>
+            <dt>Modality</dt><dd>{{ $imaging->payload['modality'] ?? '—' }}</dd>
+            <dt>Region</dt><dd>{{ $imaging->payload['region'] ?? '—' }}</dd>
+            <dt>Findings</dt><dd>{{ $imaging->payload['findings'] ?? '—' }}</dd>
+            <dt>Impression</dt><dd>{{ $imaging->payload['impression'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No imaging recorded.</p>
+    @endif
+
+    <h2>Diagnosis & plan</h2>
+    @if ($plan)
+        <dl>
+            <dt>Diagnosis</dt><dd>{{ $plan->payload['diagnosis'] ?? '—' }}</dd>
+            <dt>Plan</dt><dd>{{ $plan->payload['plan'] ?? '—' }}</dd>
+            <dt>Weight-bearing</dt><dd>{{ $plan->payload['weight_bearing'] ?? '—' }}</dd>
+            <dt>Follow-up</dt><dd>{{ $plan->payload['follow_up'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No plan recorded.</p>
+    @endif
+
+    <h2>Procedure / cast</h2>
+    @if ($procedure)
+        <dl>
+            <dt>Procedure</dt><dd>{{ $procedure->payload['procedure'] ?? '—' }}</dd>
+            <dt>Outcome</dt><dd>{{ $procedure->payload['outcome'] ?? '—' }}</dd>
+            <dt>Plan</dt><dd>{{ $procedure->payload['post_procedure_plan'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No procedure recorded.</p>
+    @endif
+
+    <script>window.print();</script>
+</body>
+</html>

resources/views/care/specialty/orthopedics/reports.blade.php

@@ -0,0 +1,88 @@
+<x-app-layout title="Orthopedics reports">
+    <div class="space-y-6">
+        <div class="flex flex-wrap items-center justify-between gap-3">
+            <div>
+                <h1 class="text-xl font-semibold text-slate-900">Orthopedics reports</h1>
+                <p class="mt-1 text-sm text-slate-500">Arrivals, neurovascular compromise, diagnoses, procedures, length of stay, and orthopedics revenue.</p>
+            </div>
+            <a href="{{ route('care.specialty.show', 'orthopedics') }}" class="text-sm font-medium text-indigo-600">← Specialty home</a>
+        </div>
+
+        <form method="GET" class="flex flex-wrap items-end gap-3 rounded-2xl border border-slate-200 bg-white p-4">
+            <div>
+                <label class="block text-xs font-medium text-slate-600">From</label>
+                <input type="date" name="from" value="{{ $report['from'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">To</label>
+                <input type="date" name="to" value="{{ $report['to'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <button type="submit" class="rounded-xl bg-indigo-600 px-4 py-2 text-sm font-semibold text-white">Apply</button>
+        </form>
+
+        <div class="grid gap-4 sm:grid-cols-4">
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Arrivals today</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['arrivals_today']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Completed today</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['completed_today']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">N/V compromise open</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-rose-700">{{ number_format($report['nv_compromise_open']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Avg LOS (range)</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">
+                    {{ $report['avg_los_minutes'] !== null ? $report['avg_los_minutes'].' min' : '—' }}
+                </p>
+            </div>
+        </div>
+
+        <div class="grid gap-4 lg:grid-cols-2">
+            <section class="rounded-2xl border border-slate-200 bg-white p-5">
+                <h2 class="text-sm font-semibold text-slate-900">Diagnoses</h2>
+                <ul class="mt-3 space-y-2 text-sm">
+                    @forelse ($report['diagnosis_breakdown'] as $row)
+                        <li class="flex justify-between gap-3">
+                            <span>{{ $row['diagnosis'] }}</span>
+                            <span class="tabular-nums text-slate-600">{{ $row['total'] }}</span>
+                        </li>
+                    @empty
+                        <li class="text-slate-500">No care plans in range.</li>
+                    @endforelse
+                </ul>
+            </section>
+
+            <section class="rounded-2xl border border-slate-200 bg-white p-5">
+                <h2 class="text-sm font-semibold text-slate-900">Procedures</h2>
+                <ul class="mt-3 space-y-2 text-sm">
+                    @forelse ($report['procedure_breakdown'] as $row)
+                        <li class="flex justify-between gap-3">
+                            <span>{{ $row['procedure'] }}</span>
+                            <span class="tabular-nums text-slate-600">{{ $row['total'] }}</span>
+                        </li>
+                    @empty
+                        <li class="text-slate-500">No procedures in range.</li>
+                    @endforelse
+                </ul>
+            </section>
+        </div>
+
+        <section class="rounded-2xl border border-slate-200 bg-white p-5">
+            <h2 class="text-sm font-semibold text-slate-900">Orthopedics service revenue</h2>
+            <ul class="mt-3 space-y-2 text-sm">
+                @forelse ($report['revenue_by_service'] as $row)
+                    <li class="flex justify-between gap-3">
+                        <span>{{ $row->description }} <span class="text-slate-400">×{{ $row->total }}</span></span>
+                        <span class="tabular-nums">{{ $currency }} {{ number_format($row->amount_minor / 100, 2) }}</span>
+                    </li>
+                @empty
+                    <li class="text-slate-500">No billed orthopedics services in range.</li>
+                @endforelse
+            </ul>
+        </section>
+    </div>
+</x-app-layout>

resources/views/care/specialty/orthopedics/workspace-overview.blade.php

@@ -0,0 +1,71 @@
+@php
+    $hist = $orthopedicsHistory?->payload ?? [];
+    $exam = $orthopedicsExam?->payload ?? [];
+    $plan = $orthopedicsPlan?->payload ?? [];
+@endphp
+
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Orthopedics overview</h3>
+            <p class="mt-0.5 text-xs text-slate-500">History, exam, imaging, and care plan for this episode.</p>
+        </div>
+        <div class="flex flex-wrap gap-3 text-sm">
+            <a href="{{ route('care.specialty.orthopedics.print', $workspaceVisit) }}" target="_blank" class="font-medium text-indigo-600">Print summary</a>
+            <a href="{{ route('care.specialty.orthopedics.reports') }}" class="font-medium text-indigo-600">Orthopedics reports</a>
+        </div>
+    </div>
+
+    <div class="mt-4 grid gap-3 sm:grid-cols-3">
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Complaint</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $exam['chief_complaint'] ?? '—' }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ $exam['side'] ?? '—' }} {{ $exam['region'] ?? '' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Neurovascular</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $exam['neurovascular'] ?? '—' }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ $exam['fracture_classification'] ?? '—' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Diagnosis / plan</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $plan['diagnosis'] ?? 'Not set' }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ $plan['follow_up'] ?? '—' }}</p>
+        </div>
+    </div>
+
+    <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+        <div>
+            <dt class="text-slate-500">History</dt>
+            <dd class="font-medium text-slate-900">{{ $hist['history'] ?? '—' }}</dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Plan</dt>
+            <dd class="font-medium text-slate-900">{{ $plan['plan'] ?? '—' }}</dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Queue</dt>
+            <dd class="font-medium text-slate-900">
+                {{ $workspaceVisit->appointment?->queue_ticket_number ?? '—' }}
+                @if ($workspaceVisit->appointment?->queue_ticket_status)
+                    <span class="text-slate-500">({{ $workspaceVisit->appointment->queue_ticket_status }})</span>
+                @endif
+            </dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Checked in</dt>
+            <dd class="font-medium text-slate-900">{{ $workspaceVisit->checked_in_at?->format('d M Y H:i') ?? '—' }}</dd>
+        </div>
+    </dl>
+
+    @if (! empty($clinicalAlerts))
+        <div class="mt-4 space-y-1.5 border-t border-slate-100 pt-4">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Alerts</p>
+            @foreach ($clinicalAlerts as $alert)
+                <p class="text-sm {{ ($alert['severity'] ?? '') === 'critical' ? 'text-rose-700' : 'text-amber-800' }}">
+                    {{ $alert['message'] ?? '' }}
+                </p>
+            @endforeach
+        </div>
+    @endif
+</section>

resources/views/care/specialty/orthopedics/workspace-procedure.blade.php

@@ -0,0 +1,70 @@
+@php
+    $record = $orthopedicsProcedure;
+    $payload = $record?->payload ?? [];
+    $canManage = $canManageClinical ?? $canConsult ?? false;
+@endphp
+
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Procedure / cast</h3>
+            <p class="mt-0.5 text-xs text-slate-500">Completed procedures can close the orthopedics visit.</p>
+        </div>
+        <a href="{{ route('care.specialty.orthopedics.print', $workspaceVisit) }}" target="_blank" class="text-sm font-medium text-indigo-600">Print summary</a>
+    </div>
+
+    @if ($canManage)
+        <form method="POST" action="{{ route('care.specialty.orthopedics.procedure', $workspaceVisit) }}" class="mt-4 space-y-4">
+            @csrf
+            <input type="hidden" name="tab" value="procedure">
+            <div class="grid gap-3 sm:grid-cols-2">
+                @foreach ($clinicalFields ?? [] as $field)
+                    @php
+                        $name = $field['name'];
+                        $value = old('payload.'.$name, $payload[$name] ?? '');
+                        $type = $field['type'] ?? 'text';
+                    @endphp
+                    <div @class(['sm:col-span-2' => in_array($type, ['textarea'], true)])>
+                        <label class="block text-xs font-medium text-slate-600">
+                            {{ $field['label'] }}
+                            @if (! empty($field['required'])) <span class="text-rose-600">*</span> @endif
+                        </label>
+                        @if ($type === 'textarea')
+                            <textarea name="payload[{{ $name }}]" rows="{{ $field['rows'] ?? 3 }}" @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">{{ $value }}</textarea>
+                        @elseif ($type === 'select')
+                            <select name="payload[{{ $name }}]" @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                                <option value="">Select…</option>
+                                @foreach ($field['options'] ?? [] as $option)
+                                    <option value="{{ $option }}" @selected((string) $value === (string) $option)>{{ $option }}</option>
+                                @endforeach
+                            </select>
+                        @elseif ($type === 'boolean')
+                            <label class="mt-2 inline-flex items-center gap-2 text-sm text-slate-700">
+                                <input type="checkbox" name="payload[{{ $name }}]" value="1" @checked(old('payload.'.$name, ! empty($payload[$name])))>
+                                Yes
+                            </label>
+                        @else
+                            <input type="{{ $type === 'number' ? 'number' : 'text' }}" name="payload[{{ $name }}]" value="{{ $value }}"
+                                @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                        @endif
+                    </div>
+                @endforeach
+            </div>
+            <button type="submit" class="btn-primary">Save procedure</button>
+        </form>
+    @elseif ($record)
+        <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+            @foreach ($clinicalFields ?? [] as $field)
+                <div>
+                    <dt class="text-slate-500">{{ $field['label'] }}</dt>
+                    <dd class="font-medium text-slate-900">{{ $payload[$field['name']] ?? '—' }}</dd>
+                </div>
+            @endforeach
+        </dl>
+    @else
+        <p class="mt-4 text-sm text-slate-500">No procedure recorded yet.</p>
+    @endif
+</section>

resources/views/care/specialty/partials/actions-menu.blade.php

@@ -50,6 +50,9 @@
         'radiology' => 'check_in',
         'cardiology' => 'check_in',
         'psychiatry' => 'check_in',
+        'pediatrics' => 'check_in',
+        'orthopedics' => 'check_in',
+        'ent' => 'check_in',
         default => collect($stages ?? [])->pluck('code')->first(),
     };
     $defaultStartLabel = match ($moduleKey) {
@@ -62,6 +65,9 @@
         'radiology' => 'Start check-in',
         'cardiology' => 'Start check-in',
         'psychiatry' => 'Start check-in',
+        'pediatrics' => 'Start check-in',
+        'orthopedics' => 'Start check-in',
+        'ent' => 'Start check-in',
         default => 'Start',
     };
     $currentStage = $workspaceVisit?->specialty_stage;

resources/views/care/specialty/pediatrics/print.blade.php

@@ -0,0 +1,90 @@
+<!DOCTYPE html>
+<html lang="en">
+<head>
+    <meta charset="utf-8">
+    <title>Pediatrics summary · {{ $patient->fullName() }}</title>
+    <style>
+        body { font-family: system-ui, sans-serif; color: #0f172a; margin: 2rem; }
+        h1 { font-size: 1.25rem; margin: 0 0 .25rem; }
+        h2 { font-size: .95rem; margin: 1.25rem 0 .5rem; border-bottom: 1px solid #e2e8f0; padding-bottom: .25rem; }
+        .meta { color: #64748b; font-size: .875rem; }
+        dl { display: grid; grid-template-columns: 10rem 1fr; gap: .35rem .75rem; font-size: .875rem; }
+        dt { color: #64748b; }
+        dd { margin: 0; font-weight: 500; }
+        @media print { .no-print { display: none; } }
+    </style>
+</head>
+<body>
+    <p class="no-print"><a href="{{ route('care.specialty.workspace', ['module' => 'pediatrics', 'visit' => $visit]) }}">Back</a></p>
+
+    <h1>{{ $patient->fullName() }}</h1>
+    <p class="meta">
+        {{ $patient->patient_number }}
+        · Visit #{{ $visit->id }}
+        · Stage {{ $visit->specialty_stage ?? '—' }}
+        · {{ $visit->checked_in_at?->format('d M Y H:i') ?? '—' }}
+    </p>
+
+    <h2>History</h2>
+    @if ($history)
+        <dl>
+            <dt>HPI</dt><dd>{{ $history->payload['history'] ?? '—' }}</dd>
+            <dt>Birth history</dt><dd>{{ $history->payload['birth_history'] ?? '—' }}</dd>
+            <dt>Past medical</dt><dd>{{ $history->payload['past_medical'] ?? '—' }}</dd>
+            <dt>Feeding</dt><dd>{{ $history->payload['feeding'] ?? '—' }}</dd>
+            <dt>Medications</dt><dd>{{ $history->payload['medications'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No history recorded.</p>
+    @endif
+
+    <h2>Exam / growth</h2>
+    @if ($exam)
+        <dl>
+            <dt>Complaint</dt><dd>{{ $exam->payload['chief_complaint'] ?? '—' }}</dd>
+            <dt>Weight / height</dt><dd>{{ $exam->payload['weight_kg'] ?? '—' }} kg · {{ $exam->payload['height_cm'] ?? '—' }} cm</dd>
+            <dt>Growth concern</dt><dd>{{ $exam->payload['growth_concern'] ?? '—' }}</dd>
+            <dt>Immunization</dt><dd>{{ $exam->payload['immunization_status'] ?? '—' }}</dd>
+            <dt>Exam</dt><dd>{{ $exam->payload['examination'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No exam recorded.</p>
+    @endif
+
+    <h2>Investigations</h2>
+    @if ($investigation)
+        <dl>
+            <dt>Investigation</dt><dd>{{ $investigation->payload['investigation'] ?? '—' }}</dd>
+            <dt>Findings</dt><dd>{{ $investigation->payload['findings'] ?? '—' }}</dd>
+            <dt>Impression</dt><dd>{{ $investigation->payload['impression'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No investigation recorded.</p>
+    @endif
+
+    <h2>Diagnosis & plan</h2>
+    @if ($plan)
+        <dl>
+            <dt>Diagnosis</dt><dd>{{ $plan->payload['diagnosis'] ?? '—' }}</dd>
+            <dt>Plan</dt><dd>{{ $plan->payload['plan'] ?? '—' }}</dd>
+            <dt>Medications</dt><dd>{{ $plan->payload['medications'] ?? '—' }}</dd>
+            <dt>Follow-up</dt><dd>{{ $plan->payload['follow_up'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No plan recorded.</p>
+    @endif
+
+    <h2>Treatment / immunization</h2>
+    @if ($treatment)
+        <dl>
+            <dt>Treatment</dt><dd>{{ $treatment->payload['treatment'] ?? '—' }}</dd>
+            <dt>Outcome</dt><dd>{{ $treatment->payload['outcome'] ?? '—' }}</dd>
+            <dt>Plan</dt><dd>{{ $treatment->payload['post_treatment_plan'] ?? '—' }}</dd>
+        </dl>
+    @else
+        <p class="meta">No treatment recorded.</p>
+    @endif
+
+    <script>window.print();</script>
+</body>
+</html>

resources/views/care/specialty/pediatrics/reports.blade.php

@@ -0,0 +1,88 @@
+<x-app-layout title="Pediatrics reports">
+    <div class="space-y-6">
+        <div class="flex flex-wrap items-center justify-between gap-3">
+            <div>
+                <h1 class="text-xl font-semibold text-slate-900">Pediatrics reports</h1>
+                <p class="mt-1 text-sm text-slate-500">Arrivals, growth concerns, diagnoses, treatments, length of stay, and pediatrics revenue.</p>
+            </div>
+            <a href="{{ route('care.specialty.show', 'pediatrics') }}" class="text-sm font-medium text-indigo-600">← Specialty home</a>
+        </div>
+
+        <form method="GET" class="flex flex-wrap items-end gap-3 rounded-2xl border border-slate-200 bg-white p-4">
+            <div>
+                <label class="block text-xs font-medium text-slate-600">From</label>
+                <input type="date" name="from" value="{{ $report['from'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">To</label>
+                <input type="date" name="to" value="{{ $report['to'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <button type="submit" class="rounded-xl bg-indigo-600 px-4 py-2 text-sm font-semibold text-white">Apply</button>
+        </form>
+
+        <div class="grid gap-4 sm:grid-cols-4">
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Arrivals today</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['arrivals_today']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Completed today</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['completed_today']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Growth concern open</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-rose-700">{{ number_format($report['growth_concern_open']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Avg LOS (range)</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">
+                    {{ $report['avg_los_minutes'] !== null ? $report['avg_los_minutes'].' min' : '—' }}
+                </p>
+            </div>
+        </div>
+
+        <div class="grid gap-4 lg:grid-cols-2">
+            <section class="rounded-2xl border border-slate-200 bg-white p-5">
+                <h2 class="text-sm font-semibold text-slate-900">Diagnoses</h2>
+                <ul class="mt-3 space-y-2 text-sm">
+                    @forelse ($report['diagnosis_breakdown'] as $row)
+                        <li class="flex justify-between gap-3">
+                            <span>{{ $row['diagnosis'] }}</span>
+                            <span class="tabular-nums text-slate-600">{{ $row['total'] }}</span>
+                        </li>
+                    @empty
+                        <li class="text-slate-500">No care plans in range.</li>
+                    @endforelse
+                </ul>
+            </section>
+
+            <section class="rounded-2xl border border-slate-200 bg-white p-5">
+                <h2 class="text-sm font-semibold text-slate-900">Treatments</h2>
+                <ul class="mt-3 space-y-2 text-sm">
+                    @forelse ($report['treatment_breakdown'] as $row)
+                        <li class="flex justify-between gap-3">
+                            <span>{{ $row['treatment'] }}</span>
+                            <span class="tabular-nums text-slate-600">{{ $row['total'] }}</span>
+                        </li>
+                    @empty
+                        <li class="text-slate-500">No treatments in range.</li>
+                    @endforelse
+                </ul>
+            </section>
+        </div>
+
+        <section class="rounded-2xl border border-slate-200 bg-white p-5">
+            <h2 class="text-sm font-semibold text-slate-900">Pediatrics service revenue</h2>
+            <ul class="mt-3 space-y-2 text-sm">
+                @forelse ($report['revenue_by_service'] as $row)
+                    <li class="flex justify-between gap-3">
+                        <span>{{ $row->description }} <span class="text-slate-400">×{{ $row->total }}</span></span>
+                        <span class="tabular-nums">{{ $currency }} {{ number_format($row->amount_minor / 100, 2) }}</span>
+                    </li>
+                @empty
+                    <li class="text-slate-500">No billed pediatrics services in range.</li>
+                @endforelse
+            </ul>
+        </section>
+    </div>
+</x-app-layout>

resources/views/care/specialty/pediatrics/workspace-overview.blade.php

@@ -0,0 +1,73 @@
+@php
+    $hist = $pediatricsHistory?->payload ?? [];
+    $exam = $pediatricsExam?->payload ?? [];
+    $plan = $pediatricsPlan?->payload ?? [];
+@endphp
+
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Pediatrics overview</h3>
+            <p class="mt-0.5 text-xs text-slate-500">History, growth / exam, investigations, and care plan for this episode.</p>
+        </div>
+        <div class="flex flex-wrap gap-3 text-sm">
+            <a href="{{ route('care.specialty.pediatrics.print', $workspaceVisit) }}" target="_blank" class="font-medium text-indigo-600">Print summary</a>
+            <a href="{{ route('care.specialty.pediatrics.reports') }}" class="font-medium text-indigo-600">Pediatrics reports</a>
+        </div>
+    </div>
+
+    <div class="mt-4 grid gap-3 sm:grid-cols-3">
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Complaint</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $exam['chief_complaint'] ?? '—' }}</p>
+            <p class="mt-1 text-xs text-slate-500">Growth {{ $exam['growth_concern'] ?? '—' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Growth</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">
+                {{ $exam['weight_kg'] ?? '—' }} kg · {{ $exam['height_cm'] ?? '—' }} cm
+            </p>
+            <p class="mt-1 text-xs text-slate-500">HC {{ $exam['head_circumference_cm'] ?? '—' }} · Temp {{ $exam['temperature_c'] ?? '—' }}°C</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Diagnosis / plan</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $plan['diagnosis'] ?? 'Not set' }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ $plan['follow_up'] ?? '—' }}</p>
+        </div>
+    </div>
+
+    <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+        <div>
+            <dt class="text-slate-500">History</dt>
+            <dd class="font-medium text-slate-900">{{ $hist['history'] ?? '—' }}</dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Plan</dt>
+            <dd class="font-medium text-slate-900">{{ $plan['plan'] ?? '—' }}</dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Queue</dt>
+            <dd class="font-medium text-slate-900">
+                {{ $workspaceVisit->appointment?->queue_ticket_number ?? '—' }}
+                @if ($workspaceVisit->appointment?->queue_ticket_status)
+                    <span class="text-slate-500">({{ $workspaceVisit->appointment->queue_ticket_status }})</span>
+                @endif
+            </dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Checked in</dt>
+            <dd class="font-medium text-slate-900">{{ $workspaceVisit->checked_in_at?->format('d M Y H:i') ?? '—' }}</dd>
+        </div>
+    </dl>
+
+    @if (! empty($clinicalAlerts))
+        <div class="mt-4 space-y-1.5 border-t border-slate-100 pt-4">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Alerts</p>
+            @foreach ($clinicalAlerts as $alert)
+                <p class="text-sm {{ ($alert['severity'] ?? '') === 'critical' ? 'text-rose-700' : 'text-amber-800' }}">
+                    {{ $alert['message'] ?? '' }}
+                </p>
+            @endforeach
+        </div>
+    @endif
+</section>

resources/views/care/specialty/pediatrics/workspace-treatment.blade.php

@@ -0,0 +1,70 @@
+@php
+    $record = $pediatricsTreatment;
+    $payload = $record?->payload ?? [];
+    $canManage = $canManageClinical ?? $canConsult ?? false;
+@endphp
+
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Treatment / immunization</h3>
+            <p class="mt-0.5 text-xs text-slate-500">Completed treatments can close the pediatrics visit.</p>
+        </div>
+        <a href="{{ route('care.specialty.pediatrics.print', $workspaceVisit) }}" target="_blank" class="text-sm font-medium text-indigo-600">Print summary</a>
+    </div>
+
+    @if ($canManage)
+        <form method="POST" action="{{ route('care.specialty.pediatrics.treatment', $workspaceVisit) }}" class="mt-4 space-y-4">
+            @csrf
+            <input type="hidden" name="tab" value="treatment">
+            <div class="grid gap-3 sm:grid-cols-2">
+                @foreach ($clinicalFields ?? [] as $field)
+                    @php
+                        $name = $field['name'];
+                        $value = old('payload.'.$name, $payload[$name] ?? '');
+                        $type = $field['type'] ?? 'text';
+                    @endphp
+                    <div @class(['sm:col-span-2' => in_array($type, ['textarea'], true)])>
+                        <label class="block text-xs font-medium text-slate-600">
+                            {{ $field['label'] }}
+                            @if (! empty($field['required'])) <span class="text-rose-600">*</span> @endif
+                        </label>
+                        @if ($type === 'textarea')
+                            <textarea name="payload[{{ $name }}]" rows="{{ $field['rows'] ?? 3 }}" @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">{{ $value }}</textarea>
+                        @elseif ($type === 'select')
+                            <select name="payload[{{ $name }}]" @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                                <option value="">Select…</option>
+                                @foreach ($field['options'] ?? [] as $option)
+                                    <option value="{{ $option }}" @selected((string) $value === (string) $option)>{{ $option }}</option>
+                                @endforeach
+                            </select>
+                        @elseif ($type === 'boolean')
+                            <label class="mt-2 inline-flex items-center gap-2 text-sm text-slate-700">
+                                <input type="checkbox" name="payload[{{ $name }}]" value="1" @checked(old('payload.'.$name, ! empty($payload[$name])))>
+                                Yes
+                            </label>
+                        @else
+                            <input type="{{ $type === 'number' ? 'number' : 'text' }}" name="payload[{{ $name }}]" value="{{ $value }}"
+                                @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                        @endif
+                    </div>
+                @endforeach
+            </div>
+            <button type="submit" class="btn-primary">Save treatment</button>
+        </form>
+    @elseif ($record)
+        <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+            @foreach ($clinicalFields ?? [] as $field)
+                <div>
+                    <dt class="text-slate-500">{{ $field['label'] }}</dt>
+                    <dd class="font-medium text-slate-900">{{ $payload[$field['name']] ?? '—' }}</dd>
+                </div>
+            @endforeach
+        </dl>
+    @else
+        <p class="mt-4 text-sm text-slate-500">No treatment recorded yet.</p>
+    @endif
+</section>

resources/views/care/specialty/sections/workspace.blade.php

@@ -73,6 +73,12 @@
             @include('care.specialty.cardiology.workspace-'.$activeTab)
         @elseif ($moduleKey === 'psychiatry' && in_array($activeTab, ['overview', 'followup'], true))
             @include('care.specialty.psychiatry.workspace-'.$activeTab)
+        @elseif ($moduleKey === 'pediatrics' && in_array($activeTab, ['overview', 'treatment'], true))
+            @include('care.specialty.pediatrics.workspace-'.$activeTab)
+        @elseif ($moduleKey === 'orthopedics' && in_array($activeTab, ['overview', 'procedure'], true))
+            @include('care.specialty.orthopedics.workspace-'.$activeTab)
+        @elseif ($moduleKey === 'ent' && in_array($activeTab, ['overview', 'procedure'], true))
+            @include('care.specialty.ent.workspace-'.$activeTab)
         @elseif ($activeTab === 'billing')
             <section class="rounded-2xl border border-slate-200 bg-white p-5">
                 <h3 class="text-sm font-semibold text-slate-900">

resources/views/care/specialty/shell.blade.php

@@ -52,6 +52,15 @@
                     @if ($moduleKey === 'psychiatry')
                         <a href="{{ route('care.specialty.psychiatry.reports') }}" class="text-slate-600 hover:text-slate-900">Reports</a>
                     @endif
+                    @if ($moduleKey === 'pediatrics')
+                        <a href="{{ route('care.specialty.pediatrics.reports') }}" class="text-slate-600 hover:text-slate-900">Reports</a>
+                    @endif
+                    @if ($moduleKey === 'orthopedics')
+                        <a href="{{ route('care.specialty.orthopedics.reports') }}" class="text-slate-600 hover:text-slate-900">Reports</a>
+                    @endif
+                    @if ($moduleKey === 'ent')
+                        <a href="{{ route('care.specialty.ent.reports') }}" class="text-slate-600 hover:text-slate-900">Reports</a>
+                    @endif
                     <a href="{{ route('care.specialty.history', $moduleKey) }}" class="text-slate-600 hover:text-slate-900">History</a>
                     @if ($canManageClinical ?? $canManageSpecialty ?? true)
                         <a href="{{ route('care.specialty.billing', $moduleKey) }}" class="text-slate-600 hover:text-slate-900">Billing</a>

routes/web.php

@@ -47,6 +47,9 @@ use App\Http\Controllers\Care\MaternityWorkspaceController;
 use App\Http\Controllers\Care\RadiologyWorkspaceController;
 use App\Http\Controllers\Care\CardiologyWorkspaceController;
 use App\Http\Controllers\Care\PsychiatryWorkspaceController;
+use App\Http\Controllers\Care\PediatricsWorkspaceController;
+use App\Http\Controllers\Care\OrthopedicsWorkspaceController;
+use App\Http\Controllers\Care\EntWorkspaceController;
 use App\Http\Controllers\Care\SpecialtyModuleController;
 use App\Http\Controllers\Care\VisitWorkflowController;
 use App\Http\Controllers\NotificationController;
@@ -135,6 +138,9 @@ Route::middleware(['auth', 'platform.session'])->group(function () {
             Route::get('/specialty/radiology/reports', [RadiologyWorkspaceController::class, 'reports'])->name('care.specialty.radiology.reports');
             Route::get('/specialty/cardiology/reports', [CardiologyWorkspaceController::class, 'reports'])->name('care.specialty.cardiology.reports');
             Route::get('/specialty/psychiatry/reports', [PsychiatryWorkspaceController::class, 'reports'])->name('care.specialty.psychiatry.reports');
+            Route::get('/specialty/pediatrics/reports', [PediatricsWorkspaceController::class, 'reports'])->name('care.specialty.pediatrics.reports');
+            Route::get('/specialty/orthopedics/reports', [OrthopedicsWorkspaceController::class, 'reports'])->name('care.specialty.orthopedics.reports');
+            Route::get('/specialty/ent/reports', [EntWorkspaceController::class, 'reports'])->name('care.specialty.ent.reports');
             Route::get('/specialty/{module}/workspace/{visit?}', [SpecialtyModuleController::class, 'workspace'])->name('care.specialty.workspace');
             Route::post('/specialty/{module}/workspace/{visit}/clinical', [SpecialtyModuleController::class, 'saveClinical'])->name('care.specialty.clinical.save');
             Route::post('/specialty/{module}/workspace/{visit}/documents', [SpecialtyModuleController::class, 'uploadDocument'])->name('care.specialty.documents.upload');
@@ -186,6 +192,15 @@ Route::middleware(['auth', 'platform.session'])->group(function () {
             Route::post('/specialty/psychiatry/workspace/{visit}/stage', [PsychiatryWorkspaceController::class, 'setStage'])->name('care.specialty.psychiatry.stage');
             Route::post('/specialty/psychiatry/workspace/{visit}/followup', [PsychiatryWorkspaceController::class, 'saveFollowUp'])->name('care.specialty.psychiatry.followup');
             Route::get('/specialty/psychiatry/workspace/{visit}/print', [PsychiatryWorkspaceController::class, 'printSummary'])->name('care.specialty.psychiatry.print');
+            Route::post('/specialty/pediatrics/workspace/{visit}/stage', [PediatricsWorkspaceController::class, 'setStage'])->name('care.specialty.pediatrics.stage');
+            Route::post('/specialty/pediatrics/workspace/{visit}/treatment', [PediatricsWorkspaceController::class, 'saveTreatment'])->name('care.specialty.pediatrics.treatment');
+            Route::get('/specialty/pediatrics/workspace/{visit}/print', [PediatricsWorkspaceController::class, 'printSummary'])->name('care.specialty.pediatrics.print');
+            Route::post('/specialty/orthopedics/workspace/{visit}/stage', [OrthopedicsWorkspaceController::class, 'setStage'])->name('care.specialty.orthopedics.stage');
+            Route::post('/specialty/orthopedics/workspace/{visit}/procedure', [OrthopedicsWorkspaceController::class, 'saveProcedure'])->name('care.specialty.orthopedics.procedure');
+            Route::get('/specialty/orthopedics/workspace/{visit}/print', [OrthopedicsWorkspaceController::class, 'printSummary'])->name('care.specialty.orthopedics.print');
+            Route::post('/specialty/ent/workspace/{visit}/stage', [EntWorkspaceController::class, 'setStage'])->name('care.specialty.ent.stage');
+            Route::post('/specialty/ent/workspace/{visit}/procedure', [EntWorkspaceController::class, 'saveProcedure'])->name('care.specialty.ent.procedure');
+            Route::get('/specialty/ent/workspace/{visit}/print', [EntWorkspaceController::class, 'printSummary'])->name('care.specialty.ent.print');
             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::post('/specialty/{module}/refer', [SpecialtyModuleController::class, 'refer'])->name('care.specialty.refer');

tests/Feature/CareEntSuiteTest.php

@@ -0,0 +1,234 @@
+<?php
+
+namespace Tests\Feature;
+
+use App\Http\Middleware\EnsurePlatformSession;
+use App\Models\Appointment;
+use App\Models\Branch;
+use App\Models\Department;
+use App\Models\Member;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\User;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyModuleService;
+use Illuminate\Foundation\Testing\RefreshDatabase;
+use Tests\TestCase;
+
+class CareEntSuiteTest extends TestCase
+{
+    use RefreshDatabase;
+
+    protected User $owner;
+
+    protected Organization $organization;
+
+    protected Branch $branch;
+
+    protected Patient $patient;
+
+    protected Visit $visit;
+
+    protected function setUp(): void
+    {
+        parent::setUp();
+        $this->withoutMiddleware(EnsurePlatformSession::class);
+
+        $this->owner = User::create([
+            'public_id' => 'ent-owner',
+            'name' => 'Owner',
+            'email' => 'ent-owner@example.com',
+        ]);
+
+        $this->organization = Organization::create([
+            'owner_ref' => $this->owner->public_id,
+            'name' => 'ENT Clinic',
+            'slug' => 'ent-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',
+            'branch_id' => null,
+        ]);
+
+        $this->branch = Branch::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'name' => 'Main',
+            'is_active' => true,
+        ]);
+
+        app(SpecialtyModuleService::class)->activate(
+            $this->organization,
+            $this->owner->public_id,
+            'ent',
+        );
+
+        $department = Department::query()
+            ->where('branch_id', $this->branch->id)
+            ->where('type', 'ent')
+            ->firstOrFail();
+
+        $this->patient = Patient::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_number' => 'P-ENT-SUITE',
+            'first_name' => 'Esi',
+            'last_name' => 'Throat',
+            'gender' => 'female',
+            'date_of_birth' => '1988-09-02',
+        ]);
+
+        $this->visit = Visit::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'status' => Visit::STATUS_IN_PROGRESS,
+            'checked_in_at' => now(),
+            'specialty_stage' => 'check_in',
+        ]);
+
+        Appointment::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'department_id' => $department->id,
+            'visit_id' => $this->visit->id,
+            'type' => Appointment::TYPE_WALK_IN,
+            'status' => Appointment::STATUS_IN_CONSULTATION,
+            'scheduled_at' => now(),
+            'waiting_at' => now(),
+            'checked_in_at' => now(),
+            'started_at' => now(),
+        ]);
+    }
+
+    public function test_overview_and_exam_tabs_render(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'ent',
+                'visit' => $this->visit,
+                'tab' => 'overview',
+            ]))
+            ->assertOk()
+            ->assertSee('ENT overview')
+            ->assertSee('data-care-stage-bar', false)
+            ->assertSee('Start history')
+            ->assertSee('ENT reports');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'ent',
+                'visit' => $this->visit,
+                'tab' => 'exam',
+            ]))
+            ->assertOk()
+            ->assertSee('Chief complaint')
+            ->assertSee('Airway concern');
+    }
+
+    public function test_exam_sets_stage_and_airway_alert(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.clinical.save', [
+                'module' => 'ent',
+                'visit' => $this->visit,
+            ]), [
+                'tab' => 'exam',
+                'payload' => [
+                    'chief_complaint' => 'Sore throat with muffled voice',
+                    'throat_findings' => 'Unilateral tonsillar bulge',
+                    'airway_concern' => '1',
+                    'exam_summary' => 'Possible peritonsillar abscess',
+                ],
+            ])
+            ->assertRedirect();
+
+        $this->assertSame('exam', $this->visit->fresh()->specialty_stage);
+
+        $record = SpecialtyClinicalRecord::query()
+            ->where('visit_id', $this->visit->id)
+            ->where('record_type', 'ent_exam')
+            ->firstOrFail();
+
+        $codes = collect($record->alerts)->pluck('code')->all();
+        $this->assertContains('ent.airway_concern', $codes);
+    }
+
+    public function test_stage_advance_and_procedure_completes_visit(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.ent.stage', $this->visit), [
+                'stage' => 'procedure',
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'ent',
+                'visit' => $this->visit,
+                'tab' => 'procedure',
+            ]));
+
+        $this->assertSame('procedure', $this->visit->fresh()->specialty_stage);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.ent.procedure', $this->visit), [
+                'tab' => 'procedure',
+                'payload' => [
+                    'procedure' => 'Needle aspiration of PTA',
+                    'indication' => 'Peritonsillar abscess',
+                    'outcome' => 'Completed uneventfully',
+                    'post_procedure_plan' => 'IV antibiotics; airway observation',
+                ],
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'ent',
+                'visit' => $this->visit,
+                'tab' => 'procedure',
+            ]));
+
+        $this->assertSame('completed', $this->visit->fresh()->specialty_stage);
+        $this->assertSame(Visit::STATUS_COMPLETED, $this->visit->fresh()->status);
+        $this->assertDatabaseHas('care_specialty_clinical_records', [
+            'visit_id' => $this->visit->id,
+            'record_type' => 'ent_procedure',
+            'status' => SpecialtyClinicalRecord::STATUS_COMPLETED,
+        ]);
+    }
+
+    public function test_reports_and_print(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.ent.reports'))
+            ->assertOk()
+            ->assertSee('ENT reports')
+            ->assertSee('Arrivals today');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.ent.print', $this->visit))
+            ->assertOk()
+            ->assertSee('ENT summary')
+            ->assertSee($this->patient->fullName());
+    }
+
+    public function test_list_index_does_not_auto_open_patient(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.show', 'ent'))
+            ->assertOk()
+            ->assertDontSee('ENT overview');
+    }
+}

tests/Feature/CareOrthopedicsSuiteTest.php

@@ -0,0 +1,236 @@
+<?php
+
+namespace Tests\Feature;
+
+use App\Http\Middleware\EnsurePlatformSession;
+use App\Models\Appointment;
+use App\Models\Branch;
+use App\Models\Department;
+use App\Models\Member;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\User;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyModuleService;
+use Illuminate\Foundation\Testing\RefreshDatabase;
+use Tests\TestCase;
+
+class CareOrthopedicsSuiteTest extends TestCase
+{
+    use RefreshDatabase;
+
+    protected User $owner;
+
+    protected Organization $organization;
+
+    protected Branch $branch;
+
+    protected Patient $patient;
+
+    protected Visit $visit;
+
+    protected function setUp(): void
+    {
+        parent::setUp();
+        $this->withoutMiddleware(EnsurePlatformSession::class);
+
+        $this->owner = User::create([
+            'public_id' => 'ort-owner',
+            'name' => 'Owner',
+            'email' => 'ort-owner@example.com',
+        ]);
+
+        $this->organization = Organization::create([
+            'owner_ref' => $this->owner->public_id,
+            'name' => 'Orthopedics Clinic',
+            'slug' => 'orthopedics-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',
+            'branch_id' => null,
+        ]);
+
+        $this->branch = Branch::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'name' => 'Main',
+            'is_active' => true,
+        ]);
+
+        app(SpecialtyModuleService::class)->activate(
+            $this->organization,
+            $this->owner->public_id,
+            'orthopedics',
+        );
+
+        $department = Department::query()
+            ->where('branch_id', $this->branch->id)
+            ->where('type', 'orthopedics')
+            ->firstOrFail();
+
+        $this->patient = Patient::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_number' => 'P-ORT-SUITE',
+            'first_name' => 'Kofi',
+            'last_name' => 'Fracture',
+            'gender' => 'male',
+            'date_of_birth' => '1990-06-10',
+        ]);
+
+        $this->visit = Visit::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'status' => Visit::STATUS_IN_PROGRESS,
+            'checked_in_at' => now(),
+            'specialty_stage' => 'check_in',
+        ]);
+
+        Appointment::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'department_id' => $department->id,
+            'visit_id' => $this->visit->id,
+            'type' => Appointment::TYPE_WALK_IN,
+            'status' => Appointment::STATUS_IN_CONSULTATION,
+            'scheduled_at' => now(),
+            'waiting_at' => now(),
+            'checked_in_at' => now(),
+            'started_at' => now(),
+        ]);
+    }
+
+    public function test_overview_and_exam_tabs_render(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'orthopedics',
+                'visit' => $this->visit,
+                'tab' => 'overview',
+            ]))
+            ->assertOk()
+            ->assertSee('Orthopedics overview')
+            ->assertSee('data-care-stage-bar', false)
+            ->assertSee('Procedure / cast')
+            ->assertSee('Start history')
+            ->assertSee('Orthopedics reports');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'orthopedics',
+                'visit' => $this->visit,
+                'tab' => 'exam',
+            ]))
+            ->assertOk()
+            ->assertSee('Chief complaint')
+            ->assertSee('Neurovascular status');
+    }
+
+    public function test_exam_sets_stage_and_nv_alert(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.clinical.save', [
+                'module' => 'orthopedics',
+                'visit' => $this->visit,
+            ]), [
+                'tab' => 'exam',
+                'payload' => [
+                    'chief_complaint' => 'Wrist deformity',
+                    'side' => 'Right',
+                    'region' => 'Distal radius',
+                    'neurovascular' => 'Sensory deficit',
+                    'exam_findings' => 'Closed injury',
+                ],
+            ])
+            ->assertRedirect();
+
+        $this->assertSame('exam', $this->visit->fresh()->specialty_stage);
+
+        $record = SpecialtyClinicalRecord::query()
+            ->where('visit_id', $this->visit->id)
+            ->where('record_type', 'ortho_exam')
+            ->firstOrFail();
+
+        $codes = collect($record->alerts)->pluck('code')->all();
+        $this->assertContains('ort.nv_deficit', $codes);
+    }
+
+    public function test_stage_advance_and_procedure_completes_visit(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.orthopedics.stage', $this->visit), [
+                'stage' => 'procedure',
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'orthopedics',
+                'visit' => $this->visit,
+                'tab' => 'procedure',
+            ]));
+
+        $this->assertSame('procedure', $this->visit->fresh()->specialty_stage);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.orthopedics.procedure', $this->visit), [
+                'tab' => 'procedure',
+                'payload' => [
+                    'procedure' => 'Closed reduction + cast',
+                    'indication' => 'Displaced distal radius fracture',
+                    'outcome' => 'Completed uneventfully',
+                    'post_procedure_plan' => 'Elevate; cast check in 1 week',
+                ],
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'orthopedics',
+                'visit' => $this->visit,
+                'tab' => 'procedure',
+            ]));
+
+        $this->assertSame('completed', $this->visit->fresh()->specialty_stage);
+        $this->assertSame(Visit::STATUS_COMPLETED, $this->visit->fresh()->status);
+        $this->assertDatabaseHas('care_specialty_clinical_records', [
+            'visit_id' => $this->visit->id,
+            'record_type' => 'ortho_procedure',
+            'status' => SpecialtyClinicalRecord::STATUS_COMPLETED,
+        ]);
+    }
+
+    public function test_reports_and_print(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.orthopedics.reports'))
+            ->assertOk()
+            ->assertSee('Orthopedics reports')
+            ->assertSee('Arrivals today');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.orthopedics.print', $this->visit))
+            ->assertOk()
+            ->assertSee('Orthopedics summary')
+            ->assertSee($this->patient->fullName());
+    }
+
+    public function test_list_index_does_not_auto_open_patient(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.show', 'orthopedics'))
+            ->assertOk()
+            ->assertDontSee('Orthopedics overview');
+    }
+}

tests/Feature/CarePediatricsSuiteTest.php

@@ -0,0 +1,238 @@
+<?php
+
+namespace Tests\Feature;
+
+use App\Http\Middleware\EnsurePlatformSession;
+use App\Models\Appointment;
+use App\Models\Branch;
+use App\Models\Department;
+use App\Models\Member;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\User;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyModuleService;
+use Illuminate\Foundation\Testing\RefreshDatabase;
+use Tests\TestCase;
+
+class CarePediatricsSuiteTest extends TestCase
+{
+    use RefreshDatabase;
+
+    protected User $owner;
+
+    protected Organization $organization;
+
+    protected Branch $branch;
+
+    protected Patient $patient;
+
+    protected Visit $visit;
+
+    protected function setUp(): void
+    {
+        parent::setUp();
+        $this->withoutMiddleware(EnsurePlatformSession::class);
+
+        $this->owner = User::create([
+            'public_id' => 'ped-owner',
+            'name' => 'Owner',
+            'email' => 'ped-owner@example.com',
+        ]);
+
+        $this->organization = Organization::create([
+            'owner_ref' => $this->owner->public_id,
+            'name' => 'Pediatrics Clinic',
+            'slug' => 'pediatrics-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',
+            'branch_id' => null,
+        ]);
+
+        $this->branch = Branch::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'name' => 'Main',
+            'is_active' => true,
+        ]);
+
+        app(SpecialtyModuleService::class)->activate(
+            $this->organization,
+            $this->owner->public_id,
+            'pediatrics',
+        );
+
+        $department = Department::query()
+            ->where('branch_id', $this->branch->id)
+            ->where('type', 'pediatrics')
+            ->firstOrFail();
+
+        $this->patient = Patient::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_number' => 'P-PED-SUITE',
+            'first_name' => 'Ama',
+            'last_name' => 'Child',
+            'gender' => 'female',
+            'date_of_birth' => '2024-01-15',
+        ]);
+
+        $this->visit = Visit::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'status' => Visit::STATUS_IN_PROGRESS,
+            'checked_in_at' => now(),
+            'specialty_stage' => 'check_in',
+        ]);
+
+        Appointment::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'department_id' => $department->id,
+            'visit_id' => $this->visit->id,
+            'type' => Appointment::TYPE_WALK_IN,
+            'status' => Appointment::STATUS_IN_CONSULTATION,
+            'scheduled_at' => now(),
+            'waiting_at' => now(),
+            'checked_in_at' => now(),
+            'started_at' => now(),
+        ]);
+    }
+
+    public function test_overview_and_growth_tabs_render(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'pediatrics',
+                'visit' => $this->visit,
+                'tab' => 'overview',
+            ]))
+            ->assertOk()
+            ->assertSee('Pediatrics overview')
+            ->assertSee('data-care-stage-bar', false)
+            ->assertSee('Exam / growth')
+            ->assertSee('Start history')
+            ->assertSee('Pediatrics reports');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'pediatrics',
+                'visit' => $this->visit,
+                'tab' => 'growth',
+            ]))
+            ->assertOk()
+            ->assertSee('Chief complaint')
+            ->assertSee('Growth concern');
+    }
+
+    public function test_exam_sets_stage_and_growth_alert(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.clinical.save', [
+                'module' => 'pediatrics',
+                'visit' => $this->visit,
+            ]), [
+                'tab' => 'growth',
+                'payload' => [
+                    'chief_complaint' => 'Fever',
+                    'weight_kg' => 8.2,
+                    'temperature_c' => 39.2,
+                    'growth_concern' => 'Underweight',
+                    'examination' => 'Irritable; mild dehydration',
+                ],
+            ])
+            ->assertRedirect();
+
+        $this->assertSame('exam', $this->visit->fresh()->specialty_stage);
+
+        $record = SpecialtyClinicalRecord::query()
+            ->where('visit_id', $this->visit->id)
+            ->where('record_type', 'pediatric_exam')
+            ->firstOrFail();
+
+        $codes = collect($record->alerts)->pluck('code')->all();
+        $this->assertContains('ped.growth_concern', $codes);
+        $this->assertContains('ped.fever_high', $codes);
+    }
+
+    public function test_stage_advance_and_treatment_completes_visit(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.pediatrics.stage', $this->visit), [
+                'stage' => 'treatment',
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'pediatrics',
+                'visit' => $this->visit,
+                'tab' => 'treatment',
+            ]));
+
+        $this->assertSame('treatment', $this->visit->fresh()->specialty_stage);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.pediatrics.treatment', $this->visit), [
+                'tab' => 'treatment',
+                'payload' => [
+                    'treatment' => 'Measles immunization',
+                    'vaccine_or_procedure' => 'Measles dose 1',
+                    'site_route' => 'Left upper arm / IM',
+                    'outcome' => 'Completed uneventfully',
+                    'post_treatment_plan' => 'Observe 15 minutes; fever advice',
+                ],
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'pediatrics',
+                'visit' => $this->visit,
+                'tab' => 'treatment',
+            ]));
+
+        $this->assertSame('completed', $this->visit->fresh()->specialty_stage);
+        $this->assertSame(Visit::STATUS_COMPLETED, $this->visit->fresh()->status);
+        $this->assertDatabaseHas('care_specialty_clinical_records', [
+            'visit_id' => $this->visit->id,
+            'record_type' => 'ped_treatment',
+            'status' => SpecialtyClinicalRecord::STATUS_COMPLETED,
+        ]);
+    }
+
+    public function test_reports_and_print(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.pediatrics.reports'))
+            ->assertOk()
+            ->assertSee('Pediatrics reports')
+            ->assertSee('Arrivals today');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.pediatrics.print', $this->visit))
+            ->assertOk()
+            ->assertSee('Pediatrics summary')
+            ->assertSee($this->patient->fullName());
+    }
+
+    public function test_list_index_does_not_auto_open_patient(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.show', 'pediatrics'))
+            ->assertOk()
+            ->assertDontSee('Pediatrics overview');
+    }
+}