diff --git a/src/Shentun.Peis.Application/PatientRegisters/PatientRegisterAppService.cs b/src/Shentun.Peis.Application/PatientRegisters/PatientRegisterAppService.cs
index 5d49cd0..d394c66 100644
--- a/src/Shentun.Peis.Application/PatientRegisters/PatientRegisterAppService.cs
+++ b/src/Shentun.Peis.Application/PatientRegisters/PatientRegisterAppService.cs
@@ -3135,6 +3135,10 @@ namespace Shentun.Peis.PatientRegisters
                         {
                             f.MedicalStartDate = DateTime.Now;
                             f.IsMedicalStart = 'Y';
+                            if(f.PatientRegisterNo.StartsWith("P"))
+                            {
+                                f.PatientRegisterNo = _manager.CreatePatientRegisterNo(f.MedicalCenterId).Result;
+                            }
                         }
                         f.CompleteFlag = input.CompleteFlag.Value;
                     }
diff --git a/src/Shentun.Peis.Domain/PatientRegisters/PatientRegisterManager.cs b/src/Shentun.Peis.Domain/PatientRegisters/PatientRegisterManager.cs
index 4609597..ea5c423 100644
--- a/src/Shentun.Peis.Domain/PatientRegisters/PatientRegisterManager.cs
+++ b/src/Shentun.Peis.Domain/PatientRegisters/PatientRegisterManager.cs
@@ -295,10 +295,16 @@ namespace Shentun.Peis.PatientRegisters
                 throw new ArgumentException("完成标志错误");
             }
 
+            string patientRegisterNo;
+            if (entity.CompleteFlag != PatientRegisterCompleteFlag.PreRegistration)
+            {
+                patientRegisterNo = await CreatePrePatientRegisterNo();
+            }
+            else
+            {
+                patientRegisterNo = await CreatePatientRegisterNo(entity.MedicalCenterId);
+            }
 
-
-
-            var patientRegisterNo = await CreatePatientRegisterNo(entity.MedicalCenterId);
             if (entity.MedicalTimes == 0)
             {
                 entity.MedicalTimes = await GetPatientCount(entity.PatientId);
@@ -505,7 +511,12 @@ namespace Shentun.Peis.PatientRegisters
             {
                 throw new ArgumentException("完成标志错误");
             }
-
+            if(targetEntity.CompleteFlag == PatientRegisterCompleteFlag.PreRegistration 
+                && sourceEntity.CompleteFlag == PatientRegisterCompleteFlag.Registration
+                && targetEntity.PatientRegisterNo.StartsWith("P"))
+            {
+                targetEntity.PatientRegisterNo = await CreatePatientRegisterNo(targetEntity.MedicalCenterId);
+            }
             //if (sourceEntity.MedicalTimes < 1)
             //{
             //    throw new UserFriendlyException("体检次数必须大于0");
@@ -925,6 +936,7 @@ namespace Shentun.Peis.PatientRegisters
 
                 await _primarykeyBuilderRepository.InsertAsync(primarykeyBuilderEnt, true);
             }
+            prePatientRegisterNo = "P" + prePatientRegisterNo;
             return prePatientRegisterNo;
         }
         ///// <summary>