Merge pull request 'feature/treatment-backend' (#20) from feature/treatment-backend into master

Reviewed-on: http://178.131.50.201:3000/admin/dyolink/pulls/20
2026-06-02 14:25:55 +03:30
parent 935bb8c214 633c939560
commit 468572a50f
34 changed files with 2652 additions and 1001 deletions
--- a/backend/.gitignore
+++ b/backend/.gitignore
@@ -45,6 +45,7 @@ lerna-debug.log*
 # temp directory
 .temp
 .tmp
+/uploads

 # Runtime data
 pids
--- a/backend/package-lock.json
+++ b/backend/package-lock.json
@@ -35,6 +35,7 @@
        "express-formidable": "^1.2.0",
        "express-session": "^1.19.0",
        "helmet": "^8.1.0",
+        "multer": "^2.1.1",
        "passport": "^0.7.0",
        "passport-jwt": "^4.0.1",
        "passport-local": "^1.0.0",
@@ -55,6 +56,7 @@
        "@types/express": "^5.0.0",
        "@types/express-session": "^1.18.2",
        "@types/jest": "^30.0.0",
+        "@types/multer": "^2.1.0",
        "@types/node": "^22.10.7",
        "@types/pg": "^8.16.0",
        "@types/react": "^19.2.14",
@@ -6251,6 +6253,16 @@
      "integrity": "sha512-GsCCIZDE/p3i96vtEqx+7dBUGXrc7zeSK3wwPHIaRThS+9OhWIXRqzs4d6k1SVU8g91DrNRWxWUGhp5KXQb2VA==",
      "license": "MIT"
    },
+    "node_modules/@types/multer": {
+      "version": "2.1.0",
+      "resolved": "https://registry.npmmirror.com/@types/multer/-/multer-2.1.0.tgz",
+      "integrity": "sha512-zYZb0+nJhOHtPpGDb3vqPjwpdeGlGC157VpkqNQL+UU2qwoacoQ7MpsAmUptI/0Oa127X32JzWDqQVEXp2RcIA==",
+      "dev": true,
+      "license": "MIT",
+      "dependencies": {
+        "@types/express": "*"
+      }
+    },
    "node_modules/@types/node": {
      "version": "22.19.17",
      "resolved": "https://registry.npmjs.org/@types/node/-/node-22.19.17.tgz",
@@ -12374,7 +12386,7 @@
    },
    "node_modules/multer": {
      "version": "2.1.1",
-      "resolved": "https://registry.npmjs.org/multer/-/multer-2.1.1.tgz",
+      "resolved": "https://registry.npmmirror.com/multer/-/multer-2.1.1.tgz",
      "integrity": "sha512-mo+QTzKlx8R7E5ylSXxWzGoXoZbOsRMpyitcht8By2KHvMbf3tjwosZ/Mu/XYU6UuJ3VZnODIrak5ZrPiPyB6A==",
      "license": "MIT",
      "dependencies": {
--- a/backend/package.json
+++ b/backend/package.json
@@ -41,7 +41,6 @@
    "@nestjs/swagger": "^11.2.6",
    "@nestjs/throttler": "^6.5.0",
    "@prisma/client": "^6.19.2",
-    "prisma": "^6.19.2",
    "adminjs": "^7.8.17",
    "axios": "^1.13.5",
    "bcrypt": "^6.0.0",
@@ -54,10 +53,12 @@
    "express-formidable": "^1.2.0",
    "express-session": "^1.19.0",
    "helmet": "^8.1.0",
+    "multer": "^2.1.1",
    "passport": "^0.7.0",
    "passport-jwt": "^4.0.1",
    "passport-local": "^1.0.0",
    "pg": "^8.18.0",
+    "prisma": "^6.19.2",
    "reflect-metadata": "^0.2.2",
    "rxjs": "^7.8.1",
    "styled-components": "^6.3.11",
@@ -73,6 +74,7 @@
    "@types/express": "^5.0.0",
    "@types/express-session": "^1.18.2",
    "@types/jest": "^30.0.0",
+    "@types/multer": "^2.1.0",
    "@types/node": "^22.10.7",
    "@types/pg": "^8.16.0",
    "@types/react": "^19.2.14",
--- a/backend/prisma/migrations/20260519120000_add_treatments_feature/migration.sql
+++ b/backend/prisma/migrations/20260519120000_add_treatments_feature/migration.sql
@@ -0,0 +1,154 @@
+-- CreateEnum
+CREATE TYPE "TreatmentStatus" AS ENUM ('DRAFT', 'COMPLETED');
+
+-- CreateTable
+CREATE TABLE "treatments" (
+    "id" TEXT NOT NULL,
+    "organizationId" TEXT NOT NULL,
+    "patientId" TEXT NOT NULL,
+    "appointmentId" TEXT,
+    "providerUserId" TEXT NOT NULL,
+    "title" TEXT NOT NULL,
+    "status" "TreatmentStatus" NOT NULL DEFAULT 'DRAFT',
+    "treatmentAt" TIMESTAMP(3) NOT NULL,
+    "createdAt" TIMESTAMP(3) NOT NULL DEFAULT CURRENT_TIMESTAMP,
+    "updatedAt" TIMESTAMP(3) NOT NULL,
+
+    CONSTRAINT "treatments_pkey" PRIMARY KEY ("id")
+);
+
+-- CreateTable
+CREATE TABLE "treatment_cases" (
+    "id" TEXT NOT NULL,
+    "treatmentId" TEXT NOT NULL,
+    "clientKey" TEXT,
+    "sortOrder" INTEGER NOT NULL,
+    "treatmentType" TEXT NOT NULL,
+    "teeth" JSONB NOT NULL,
+    "comment" TEXT,
+    "sentAt" TIMESTAMP(3),
+
+    CONSTRAINT "treatment_cases_pkey" PRIMARY KEY ("id")
+);
+
+-- CreateTable
+CREATE TABLE "treatment_case_attachments" (
+    "id" TEXT NOT NULL,
+    "caseId" TEXT,
+    "appointmentId" TEXT,
+    "caseClientKey" TEXT,
+    "fileName" TEXT NOT NULL,
+    "mimeType" TEXT NOT NULL,
+    "sizeBytes" INTEGER NOT NULL,
+    "storagePath" TEXT NOT NULL,
+    "createdAt" TIMESTAMP(3) NOT NULL DEFAULT CURRENT_TIMESTAMP,
+
+    CONSTRAINT "treatment_case_attachments_pkey" PRIMARY KEY ("id")
+);
+
+-- CreateTable
+CREATE TABLE "treatment_case_sends" (
+    "id" TEXT NOT NULL,
+    "caseId" TEXT NOT NULL,
+    "organizationId" TEXT NOT NULL,
+    "sentAt" TIMESTAMP(3) NOT NULL DEFAULT CURRENT_TIMESTAMP,
+
+    CONSTRAINT "treatment_case_sends_pkey" PRIMARY KEY ("id")
+);
+
+-- Migrate legacy patient_treatment_histories into treatments + single case per row
+INSERT INTO "treatments" (
+    "id",
+    "organizationId",
+    "patientId",
+    "appointmentId",
+    "providerUserId",
+    "title",
+    "status",
+    "treatmentAt",
+    "createdAt",
+    "updatedAt"
+)
+SELECT
+    h."id",
+    p."organizationId",
+    h."patientId",
+    NULL,
+    o."ownerId",
+    h."title",
+    'COMPLETED'::"TreatmentStatus",
+    h."treatmentAt",
+    h."createdAt",
+    h."updatedAt"
+FROM "patient_treatment_histories" h
+JOIN "patients" p ON p."id" = h."patientId"
+JOIN "organizations" o ON o."id" = p."organizationId";
+
+INSERT INTO "treatment_cases" (
+    "id",
+    "treatmentId",
+    "clientKey",
+    "sortOrder",
+    "treatmentType",
+    "teeth",
+    "comment",
+    "sentAt"
+)
+SELECT
+    h."id" || '-case',
+    h."id",
+    NULL,
+    0,
+    'visit',
+    CASE
+        WHEN h."tooth" IS NOT NULL AND btrim(h."tooth") <> '' THEN jsonb_build_array(h."tooth")
+        ELSE '[]'::jsonb
+    END,
+    h."notes",
+    NULL
+FROM "patient_treatment_histories" h;
+
+-- Drop legacy table
+DROP TABLE "patient_treatment_histories";
+
+-- CreateIndex
+CREATE UNIQUE INDEX "treatments_appointmentId_key" ON "treatments"("appointmentId");
+
+-- CreateIndex
+CREATE INDEX "treatments_patientId_treatmentAt_idx" ON "treatments"("patientId", "treatmentAt");
+
+-- CreateIndex
+CREATE INDEX "treatments_organizationId_status_idx" ON "treatments"("organizationId", "status");
+
+-- CreateIndex
+CREATE INDEX "treatment_cases_treatmentId_sortOrder_idx" ON "treatment_cases"("treatmentId", "sortOrder");
+
+-- CreateIndex
+CREATE INDEX "treatment_case_attachments_appointmentId_caseClientKey_idx" ON "treatment_case_attachments"("appointmentId", "caseClientKey");
+
+-- CreateIndex
+CREATE INDEX "treatment_case_attachments_caseId_idx" ON "treatment_case_attachments"("caseId");
+
+-- CreateIndex
+CREATE UNIQUE INDEX "treatment_case_sends_caseId_organizationId_key" ON "treatment_case_sends"("caseId", "organizationId");
+
+-- AddForeignKey
+ALTER TABLE "treatments" ADD CONSTRAINT "treatments_organizationId_fkey" FOREIGN KEY ("organizationId") REFERENCES "organizations"("id") ON DELETE CASCADE ON UPDATE CASCADE;
+
+-- AddForeignKey
+ALTER TABLE "treatments" ADD CONSTRAINT "treatments_patientId_fkey" FOREIGN KEY ("patientId") REFERENCES "patients"("id") ON DELETE CASCADE ON UPDATE CASCADE;
+
+-- AddForeignKey
+ALTER TABLE "treatments" ADD CONSTRAINT "treatments_appointmentId_fkey" FOREIGN KEY ("appointmentId") REFERENCES "appointments"("id") ON DELETE SET NULL ON UPDATE CASCADE;
+
+-- AddForeignKey
+ALTER TABLE "treatment_cases" ADD CONSTRAINT "treatment_cases_treatmentId_fkey" FOREIGN KEY ("treatmentId") REFERENCES "treatments"("id") ON DELETE CASCADE ON UPDATE CASCADE;
+
+-- AddForeignKey
+ALTER TABLE "treatment_case_attachments" ADD CONSTRAINT "treatment_case_attachments_caseId_fkey" FOREIGN KEY ("caseId") REFERENCES "treatment_cases"("id") ON DELETE CASCADE ON UPDATE CASCADE;
+
+-- AddForeignKey
+ALTER TABLE "treatment_case_sends" ADD CONSTRAINT "treatment_case_sends_caseId_fkey" FOREIGN KEY ("caseId") REFERENCES "treatment_cases"("id") ON DELETE CASCADE ON UPDATE CASCADE;
+
+-- AddForeignKey
+ALTER TABLE "treatment_case_sends" ADD CONSTRAINT "treatment_case_sends_organizationId_fkey" FOREIGN KEY ("organizationId") REFERENCES "organizations"("id") ON DELETE CASCADE ON UPDATE CASCADE;
--- a/backend/prisma/schema.prisma
+++ b/backend/prisma/schema.prisma
@@ -61,6 +61,8 @@ model Organization {
  sentOrganizationInvitations OrganizationInvitation[] @relation("OrganizationInvitationInviter")
  patients         Patient[]
  appointments     Appointment[]
+  treatments       Treatment[]
+  caseSends        TreatmentCaseSend[]

  createdAt DateTime @default(now())
  updatedAt DateTime @updatedAt
@@ -82,7 +84,7 @@ model Patient {
  updatedAt      DateTime @updatedAt

  organization Organization @relation(fields: [organizationId], references: [id])
-  treatments   PatientTreatmentHistory[]
+  treatments   Treatment[]
  appointments Appointment[]

  @@index([organizationId, createdAt])
@@ -90,24 +92,6 @@ model Patient {
  @@map("patients")
 }

-model PatientTreatmentHistory {
-  id          String   @id @default(uuid())
-  patientId   String
-  title       String
-  status      String
-  treatmentAt DateTime
-  tooth       String?
-  notes       String?
-  totalCost   Float?
-  createdAt   DateTime @default(now())
-  updatedAt   DateTime @updatedAt
-
-  patient Patient @relation(fields: [patientId], references: [id], onDelete: Cascade)
-
-  @@index([patientId, treatmentAt])
-  @@map("patient_treatment_histories")
-}
-
 model Appointment {
  id             String   @id @default(uuid())
  organizationId String
@@ -119,6 +103,7 @@ model Appointment {

  organization Organization @relation(fields: [organizationId], references: [id], onDelete: Cascade)
  patient      Patient      @relation(fields: [patientId], references: [id], onDelete: Cascade)
+  treatment    Treatment?

  createdAt DateTime @default(now())
  updatedAt DateTime @updatedAt
@@ -128,6 +113,84 @@ model Appointment {
  @@map("appointments")
 }

+enum TreatmentStatus {
+  DRAFT
+  COMPLETED
+}
+
+model Treatment {
+  id             String          @id @default(uuid())
+  organizationId String
+  patientId      String
+  appointmentId  String?         @unique
+  providerUserId String
+  title          String
+  status         TreatmentStatus @default(DRAFT)
+  treatmentAt    DateTime
+
+  organization Organization    @relation(fields: [organizationId], references: [id], onDelete: Cascade)
+  patient      Patient         @relation(fields: [patientId], references: [id], onDelete: Cascade)
+  appointment  Appointment?    @relation(fields: [appointmentId], references: [id], onDelete: SetNull)
+  cases        TreatmentCase[]
+
+  createdAt DateTime @default(now())
+  updatedAt DateTime @updatedAt
+
+  @@index([patientId, treatmentAt])
+  @@index([organizationId, status])
+  @@map("treatments")
+}
+
+model TreatmentCase {
+  id            String    @id @default(uuid())
+  treatmentId   String
+  clientKey     String?
+  sortOrder     Int
+  treatmentType String
+  teeth         Json
+  comment       String?
+  sentAt        DateTime?
+
+  treatment   Treatment                 @relation(fields: [treatmentId], references: [id], onDelete: Cascade)
+  attachments TreatmentCaseAttachment[]
+  sends       TreatmentCaseSend[]
+
+  @@index([treatmentId, sortOrder])
+  @@map("treatment_cases")
+}
+
+model TreatmentCaseAttachment {
+  id          String  @id @default(uuid())
+  caseId      String?
+  appointmentId String?
+  caseClientKey String?
+  fileName    String
+  mimeType    String
+  sizeBytes   Int
+  storagePath String
+
+  case TreatmentCase? @relation(fields: [caseId], references: [id], onDelete: Cascade)
+
+  createdAt DateTime @default(now())
+
+  @@index([appointmentId, caseClientKey])
+  @@index([caseId])
+  @@map("treatment_case_attachments")
+}
+
+model TreatmentCaseSend {
+  id             String   @id @default(uuid())
+  caseId         String
+  organizationId String
+  sentAt         DateTime @default(now())
+
+  case         TreatmentCase @relation(fields: [caseId], references: [id], onDelete: Cascade)
+  organization Organization  @relation(fields: [organizationId], references: [id], onDelete: Cascade)
+
+  @@unique([caseId, organizationId])
+  @@map("treatment_case_sends")
+}
+
 model Plan {
  id       String @id @default(uuid())
  name     String @unique // "Solo", "Small", "Medium", "Large", "Enterprise"
--- a/backend/src/app.module.ts
+++ b/backend/src/app.module.ts
@@ -10,6 +10,7 @@ import { PatientsModule } from './modules/patients/patients.module';
 import { StaffModule } from './modules/staff/staff.module';
 import { OrganizationModule } from './modules/organization/organization.module';
 import { AppointmentsModule } from './modules/appointments/appointments.module';
+import { TreatmentsModule } from './modules/treatments/treatments.module';

@Module({
  imports: [
@@ -21,6 +22,7 @@ import { AppointmentsModule } from './modules/appointments/appointments.module';
    AuthModule,
    PatientsModule,
    AppointmentsModule,
+    TreatmentsModule,
    StaffModule,
    OrganizationModule,
    AdminModule.forRoot(),
--- a/backend/src/modules/appointments/appointments.service.ts
+++ b/backend/src/modules/appointments/appointments.service.ts
@@ -220,6 +220,9 @@ export class AppointmentsService {
    if (names.includes('TAB_TREATMENT_EDIT')) {
      return;
    }
+    if (names.includes('TAB_TREATMENT_READ')) {
+      return;
+    }
    throw new ForbiddenException('You do not have access to appointments');
  }

--- a/backend/src/modules/patients/dto/create-treatment-history.dto.ts
+++ b/backend/src/modules/patients/dto/create-treatment-history.dto.ts
@@ -1,28 +0,0 @@
-import { IsDateString, IsNumber, IsOptional, IsString, MaxLength } from 'class-validator';
-
-export class CreateTreatmentHistoryDto {
-  @IsString()
-  @MaxLength(120)
-  title: string;
-
-  @IsString()
-  @MaxLength(40)
-  status: string;
-
-  @IsDateString()
-  treatmentAt: string;
-
-  @IsOptional()
-  @IsString()
-  @MaxLength(20)
-  tooth?: string;
-
-  @IsOptional()
-  @IsString()
-  @MaxLength(1000)
-  notes?: string;
-
-  @IsOptional()
-  @IsNumber()
-  totalCost?: number;
-}
--- a/backend/src/modules/patients/patients.controller.ts
+++ b/backend/src/modules/patients/patients.controller.ts
@@ -16,7 +16,6 @@ import { CreatePatientDto } from './dto/create-patient.dto';
 import { ListPatientsDto } from './dto/list-patients.dto';
 import { UpdatePatientDto } from './dto/update-patient.dto';
 import { PatientsService } from './patients.service';
-import { CreateTreatmentHistoryDto } from './dto/create-treatment-history.dto';

@ApiTags('patients')
@ApiBearerAuth('JWT-auth')
@@ -52,26 +51,4 @@ export class PatientsController {
    const organizationId = this.patientsService.getOrganizationIdFromUser(req.user);
    return this.patientsService.update(id, updatePatientDto, organizationId);
  }
-
-  @Get(':id/treatments')
-  @ApiOperation({ summary: 'Get patient treatment history' })
-  findTreatments(
-    @Param('id') id: string,
-    @Query('limit', new ParseIntPipe({ optional: true })) limit = 20,
-    @Req() req,
-  ) {
-    const organizationId = this.patientsService.getOrganizationIdFromUser(req.user);
-    return this.patientsService.findTreatments(id, organizationId, limit);
-  }
-
-  @Post(':id/treatments')
-  @ApiOperation({ summary: 'Add treatment history item for a patient' })
-  addTreatment(
-    @Param('id') id: string,
-    @Body() dto: CreateTreatmentHistoryDto,
-    @Req() req,
-  ) {
-    const organizationId = this.patientsService.getOrganizationIdFromUser(req.user);
-    return this.patientsService.addTreatment(id, dto, organizationId);
-  }
 }
--- a/backend/src/modules/patients/patients.service.ts
+++ b/backend/src/modules/patients/patients.service.ts
@@ -3,7 +3,6 @@ import { PrismaService } from '../../../prisma/prisma.service';
 import { CreatePatientDto } from './dto/create-patient.dto';
 import { ListPatientsDto } from './dto/list-patients.dto';
 import { UpdatePatientDto } from './dto/update-patient.dto';
-import { CreateTreatmentHistoryDto } from './dto/create-treatment-history.dto';

@Injectable()
 export class PatientsService {
@@ -89,36 +88,6 @@ export class PatientsService {
    return { success: true, data: patient };
  }

-  async findTreatments(patientId: string, organizationId: string, limit = 20) {
-    await this.ensurePatient(patientId, organizationId);
-
-    const items = await this.prisma.patientTreatmentHistory.findMany({
-      where: { patientId },
-      orderBy: [{ treatmentAt: 'desc' }],
-      take: limit,
-    });
-
-    return { success: true, data: items };
-  }
-
-  async addTreatment(
-    patientId: string,
-    dto: CreateTreatmentHistoryDto,
-    organizationId: string,
-  ) {
-    await this.ensurePatient(patientId, organizationId);
-
-    const treatment = await this.prisma.patientTreatmentHistory.create({
-      data: {
-        ...dto,
-        treatmentAt: new Date(dto.treatmentAt),
-        patientId,
-      },
-    });
-
-    return { success: true, data: treatment };
-  }
-
  private async ensurePatient(id: string, organizationId: string) {
    const patient = await this.prisma.patient.findFirst({
      where: { id, organizationId },
--- a/backend/src/modules/treatments/dto/treatment.dto.ts
+++ b/backend/src/modules/treatments/dto/treatment.dto.ts
@@ -0,0 +1,60 @@
+import {
+  ArrayMinSize,
+  IsArray,
+  IsIn,
+  IsOptional,
+  IsString,
+  IsUUID,
+  MaxLength,
+  ValidateNested,
+} from 'class-validator';
+import { Type } from 'class-transformer';
+
+const TREATMENT_TYPES = ['consultation', 'filling', 'endo', 'visit', 'hygiene'] as const;
+
+export class SaveTreatmentCaseDto {
+  @IsString()
+  @MaxLength(64)
+  clientId: string;
+
+  @IsOptional()
+  @IsUUID()
+  id?: string;
+
+  @IsIn(TREATMENT_TYPES)
+  treatmentType: string;
+
+  @IsArray()
+  @IsString({ each: true })
+  teeth: string[];
+
+  @IsOptional()
+  @IsString()
+  @MaxLength(5000)
+  comment?: string;
+
+  @IsOptional()
+  @IsArray()
+  @IsUUID(undefined, { each: true })
+  attachmentIds?: string[];
+}
+
+export class SaveTreatmentDraftDto {
+  @IsArray()
+  @ArrayMinSize(1)
+  @ValidateNested({ each: true })
+  @Type(() => SaveTreatmentCaseDto)
+  cases: SaveTreatmentCaseDto[];
+}
+
+export class SendTreatmentCaseDto {
+  @IsArray()
+  @ArrayMinSize(1)
+  @IsUUID(undefined, { each: true })
+  organizationIds: string[];
+}
+
+export class ListPatientTreatmentHistoryDto {
+  @IsOptional()
+  limit?: number;
+}
--- a/backend/src/modules/treatments/treatment.utils.spec.ts
+++ b/backend/src/modules/treatments/treatment.utils.spec.ts
@@ -0,0 +1,16 @@
+import { generateTreatmentTitle, normalizeTeeth } from './treatment.utils';
+
+describe('treatment.utils', () => {
+  it('normalizes valid FDI teeth', () => {
+    expect(normalizeTeeth(['45', '14', '14', '99'])).toEqual(['14', '45']);
+  });
+
+  it('generates a title from cases', () => {
+    expect(
+      generateTreatmentTitle([
+        { treatmentType: 'filling', teeth: ['14', '15'] },
+        { treatmentType: 'endo', teeth: ['45'] },
+      ]),
+    ).toBe('Filling 14, 15 · Endo 45');
+  });
+});
--- a/backend/src/modules/treatments/treatment.utils.ts
+++ b/backend/src/modules/treatments/treatment.utils.ts
@@ -0,0 +1,53 @@
+import { TreatmentStatus } from '@prisma/client';
+
+const TREATMENT_TYPES = ['consultation', 'filling', 'endo', 'visit', 'hygiene'] as const;
+
+export type TreatmentTypeValue = (typeof TREATMENT_TYPES)[number];
+
+export function isTreatmentType(value: string): value is TreatmentTypeValue {
+  return (TREATMENT_TYPES as readonly string[]).includes(value);
+}
+
+const FDI_TOOTH_IDS = new Set([
+  '11', '12', '13', '14', '15', '16', '17', '18',
+  '21', '22', '23', '24', '25', '26', '27', '28',
+  '31', '32', '33', '34', '35', '36', '37', '38',
+  '41', '42', '43', '44', '45', '46', '47', '48',
+]);
+
+export function normalizeTeeth(teeth: unknown): string[] {
+  if (!Array.isArray(teeth)) {
+    return [];
+  }
+  const unique = new Set<string>();
+  for (const tooth of teeth) {
+    if (typeof tooth !== 'string') continue;
+    const trimmed = tooth.trim();
+    if (FDI_TOOTH_IDS.has(trimmed)) {
+      unique.add(trimmed);
+    }
+  }
+  return [...unique].sort();
+}
+
+export function generateTreatmentTitle(
+  cases: { treatmentType: string; teeth: string[] }[],
+): string {
+  if (cases.length === 0) {
+    return 'Treatment';
+  }
+
+  const parts = cases.map((c) => {
+    const label = c.treatmentType.charAt(0).toUpperCase() + c.treatmentType.slice(1);
+    if (c.teeth.length > 0) {
+      return `${label} ${c.teeth.join(', ')}`;
+    }
+    return label;
+  });
+
+  return parts.join(' · ');
+}
+
+export function mapTreatmentStatusForApi(status: TreatmentStatus): string {
+  return status === TreatmentStatus.DRAFT ? 'draft' : 'completed';
+}
--- a/backend/src/modules/treatments/treatments.controller.ts
+++ b/backend/src/modules/treatments/treatments.controller.ts
@@ -0,0 +1,148 @@
+import {
+  Body,
+  Controller,
+  Get,
+  Param,
+  ParseIntPipe,
+  Post,
+  Put,
+  Query,
+  Req,
+  Res,
+  UploadedFiles,
+  UseGuards,
+  UseInterceptors,
+} from '@nestjs/common';
+import { FilesInterceptor } from '@nestjs/platform-express';
+import { ApiBearerAuth, ApiBody, ApiConsumes, ApiOperation, ApiTags } from '@nestjs/swagger';
+import { memoryStorage } from 'multer';
+import type { Response } from 'express';
+import { JwtAuthGuard } from '../auth/guards/jwt-auth.guard';
+import { SaveTreatmentDraftDto, SendTreatmentCaseDto } from './dto/treatment.dto';
+import { TreatmentsService } from './treatments.service';
+
+@ApiTags('treatments')
+@ApiBearerAuth('JWT-auth')
+@UseGuards(JwtAuthGuard)
+@Controller('treatments')
+export class TreatmentsController {
+  constructor(private readonly treatmentsService: TreatmentsService) {}
+
+  @Get('linked-organizations')
+  @ApiOperation({ summary: 'List active linked counterpart organizations (TAB_TREATMENT_READ)' })
+  listLinkedOrganizations(@Req() req: { user: { id: string; organizationId?: string } }) {
+    const organizationId = this.treatmentsService.getOrganizationIdFromUser(req.user);
+    return this.treatmentsService.listLinkedOrganizations(req.user.id, organizationId);
+  }
+
+  @Get('patients/:patientId/history')
+  @ApiOperation({ summary: 'List completed treatments for a patient (TAB_TREATMENT_READ)' })
+  listPatientHistory(
+    @Param('patientId') patientId: string,
+    @Query('limit', new ParseIntPipe({ optional: true })) limit = 20,
+    @Req() req: { user: { id: string; organizationId?: string } },
+  ) {
+    const organizationId = this.treatmentsService.getOrganizationIdFromUser(req.user);
+    return this.treatmentsService.listPatientHistory(
+      patientId,
+      organizationId,
+      req.user.id,
+      limit,
+    );
+  }
+
+  @Get('appointments/:appointmentId/draft')
+  @ApiOperation({ summary: 'Get draft treatment for an appointment (TAB_TREATMENT_READ)' })
+  getDraft(
+    @Param('appointmentId') appointmentId: string,
+    @Req() req: { user: { id: string; organizationId?: string } },
+  ) {
+    const organizationId = this.treatmentsService.getOrganizationIdFromUser(req.user);
+    return this.treatmentsService.getDraftForAppointment(
+      appointmentId,
+      organizationId,
+      req.user.id,
+    );
+  }
+
+  @Put('appointments/:appointmentId/draft')
+  @ApiOperation({ summary: 'Save draft treatment for an appointment (TAB_TREATMENT_EDIT)' })
+  saveDraft(
+    @Param('appointmentId') appointmentId: string,
+    @Body() dto: SaveTreatmentDraftDto,
+    @Req() req: { user: { id: string; organizationId?: string } },
+  ) {
+    const organizationId = this.treatmentsService.getOrganizationIdFromUser(req.user);
+    return this.treatmentsService.saveDraftForAppointment(
+      appointmentId,
+      dto,
+      organizationId,
+      req.user.id,
+    );
+  }
+
+  @Post('appointments/:appointmentId/cases/:caseClientKey/attachments')
+  @ApiOperation({ summary: 'Upload attachments for a draft case (TAB_TREATMENT_EDIT)' })
+  @ApiConsumes('multipart/form-data')
+  @ApiBody({
+    schema: {
+      type: 'object',
+      properties: {
+        files: {
+          type: 'array',
+          items: { type: 'string', format: 'binary' },
+        },
+      },
+    },
+  })
+  @UseInterceptors(
+    FilesInterceptor('files', 20, {
+      storage: memoryStorage(),
+    }),
+  )
+  uploadAttachments(
+    @Param('appointmentId') appointmentId: string,
+    @Param('caseClientKey') caseClientKey: string,
+    @UploadedFiles() files: Express.Multer.File[],
+    @Req() req: { user: { id: string; organizationId?: string } },
+  ) {
+    const organizationId = this.treatmentsService.getOrganizationIdFromUser(req.user);
+    return this.treatmentsService.uploadCaseAttachments(
+      appointmentId,
+      caseClientKey,
+      files,
+      organizationId,
+      req.user.id,
+    );
+  }
+
+  @Get('attachments/:attachmentId/file')
+  @ApiOperation({ summary: 'Download a treatment attachment (TAB_TREATMENT_READ)' })
+  async downloadAttachment(
+    @Param('attachmentId') attachmentId: string,
+    @Req() req: { user: { id: string; organizationId?: string } },
+    @Res() res: Response,
+  ) {
+    const organizationId = this.treatmentsService.getOrganizationIdFromUser(req.user);
+    const file = await this.treatmentsService.streamAttachmentFile(
+      attachmentId,
+      organizationId,
+      req.user.id,
+    );
+
+    res.setHeader('Content-Type', file.mimeType);
+    res.setHeader('Content-Disposition', `inline; filename="${file.fileName}"`);
+    file.stream.pipe(res);
+  }
+
+  @Post('cases/:caseId/send')
+  @ApiOperation({ summary: 'Send a treatment case to linked organizations (TAB_TREATMENT_EDIT)' })
+  sendCase(
+    @Param('caseId') caseId: string,
+    @Body() dto: SendTreatmentCaseDto,
+    @Req() req: { user: { id: string; organizationId?: string } },
+  ) {
+    const organizationId = this.treatmentsService.getOrganizationIdFromUser(req.user);
+    return this.treatmentsService.sendCase(caseId, dto, organizationId, req.user.id);
+  }
+}
--- a/backend/src/modules/treatments/treatments.module.ts
+++ b/backend/src/modules/treatments/treatments.module.ts
@@ -0,0 +1,10 @@
+import { Module } from '@nestjs/common';
+import { PrismaService } from '../../../prisma/prisma.service';
+import { TreatmentsController } from './treatments.controller';
+import { TreatmentsService } from './treatments.service';
+
+@Module({
+  controllers: [TreatmentsController],
+  providers: [TreatmentsService, PrismaService],
+})
+export class TreatmentsModule {}
--- a/backend/src/modules/treatments/treatments.service.ts
+++ b/backend/src/modules/treatments/treatments.service.ts
@@ -0,0 +1,625 @@
+import {
+  BadRequestException,
+  ForbiddenException,
+  Injectable,
+  NotFoundException,
+} from '@nestjs/common';
+import { LinkStatus, TreatmentStatus } from '@prisma/client';
+import { createReadStream, existsSync, mkdirSync } from 'fs';
+import { join } from 'path';
+import { randomUUID } from 'crypto';
+import { PrismaService } from '../../../prisma/prisma.service';
+import { SaveTreatmentDraftDto, SendTreatmentCaseDto } from './dto/treatment.dto';
+import {
+  generateTreatmentTitle,
+  isTreatmentType,
+  mapTreatmentStatusForApi,
+  normalizeTeeth,
+} from './treatment.utils';
+
+const treatmentInclude = {
+  cases: {
+    orderBy: [{ sortOrder: 'asc' as const }],
+    include: {
+      attachments: { orderBy: [{ createdAt: 'asc' as const }] },
+      sends: {
+        orderBy: [{ sentAt: 'asc' as const }],
+        include: { organization: { select: { id: true, name: true } } },
+      },
+    },
+  },
+};
+
+@Injectable()
+export class TreatmentsService {
+  private readonly uploadRoot = join(process.cwd(), 'uploads', 'treatments');
+
+  constructor(private readonly prisma: PrismaService) {}
+
+  getOrganizationIdFromUser(user: { organizationId?: string }) {
+    if (!user?.organizationId) {
+      throw new BadRequestException('Organization is not selected');
+    }
+    return user.organizationId;
+  }
+
+  async listLinkedOrganizations(userId: string, organizationId: string) {
+    await this.assertCanReadTreatment(userId, organizationId);
+
+    const [linksA, linksB] = await Promise.all([
+      this.prisma.organizationLink.findMany({
+        where: { organizationAId: organizationId, status: LinkStatus.ACTIVE },
+        include: { organizationB: { select: { id: true, name: true } } },
+      }),
+      this.prisma.organizationLink.findMany({
+        where: { organizationBId: organizationId, status: LinkStatus.ACTIVE },
+        include: { organizationA: { select: { id: true, name: true } } },
+      }),
+    ]);
+
+    const data = [
+      ...linksA.map((l) => ({
+        id: l.organizationB.id,
+        name: l.organizationB.name,
+        active: true,
+      })),
+      ...linksB.map((l) => ({
+        id: l.organizationA.id,
+        name: l.organizationA.name,
+        active: true,
+      })),
+    ].sort((a, b) => a.name.localeCompare(b.name));
+
+    return { success: true, data };
+  }
+
+  async listPatientHistory(
+    patientId: string,
+    organizationId: string,
+    actorUserId: string,
+    limit = 20,
+  ) {
+    await this.assertCanReadTreatment(actorUserId, organizationId);
+    await this.ensurePatientInOrg(patientId, organizationId);
+
+    const items = await this.prisma.treatment.findMany({
+      where: {
+        patientId,
+        organizationId,
+        status: TreatmentStatus.COMPLETED,
+      },
+      include: treatmentInclude,
+      orderBy: [{ treatmentAt: 'desc' }],
+      take: Math.min(Math.max(limit, 1), 100),
+    });
+
+    return { success: true, data: items.map((t) => this.mapTreatment(t)) };
+  }
+
+  async getDraftForAppointment(
+    appointmentId: string,
+    organizationId: string,
+    actorUserId: string,
+  ) {
+    await this.assertCanReadTreatment(actorUserId, organizationId);
+    const appointment = await this.ensureAppointmentProvider(
+      appointmentId,
+      organizationId,
+      actorUserId,
+      false,
+    );
+
+    const treatment = await this.prisma.treatment.findFirst({
+      where: {
+        appointmentId: appointment.id,
+        organizationId,
+        status: TreatmentStatus.DRAFT,
+      },
+      include: treatmentInclude,
+    });
+
+    return { success: true, data: treatment ? this.mapTreatment(treatment) : null };
+  }
+
+  async saveDraftForAppointment(
+    appointmentId: string,
+    dto: SaveTreatmentDraftDto,
+    organizationId: string,
+    actorUserId: string,
+  ) {
+    await this.assertCanEditTreatment(actorUserId, organizationId);
+    const appointment = await this.ensureAppointmentProvider(
+      appointmentId,
+      organizationId,
+      actorUserId,
+      true,
+    );
+
+    for (const c of dto.cases) {
+      if (!isTreatmentType(c.treatmentType)) {
+        throw new BadRequestException(`Invalid treatment type: ${c.treatmentType}`);
+      }
+    }
+
+    const normalizedCases = dto.cases.map((c, index) => ({
+      ...c,
+      sortOrder: index,
+      teeth: normalizeTeeth(c.teeth),
+      comment: c.comment?.trim() || null,
+      attachmentIds: c.attachmentIds ?? [],
+    }));
+
+    const title = generateTreatmentTitle(
+      normalizedCases.map((c) => ({ treatmentType: c.treatmentType, teeth: c.teeth })),
+    );
+
+    const treatment = await this.prisma.$transaction(async (tx) => {
+      const existing = await tx.treatment.findFirst({
+        where: { appointmentId: appointment.id, organizationId },
+        select: { id: true },
+      });
+
+      const saved = existing
+        ? await tx.treatment.update({
+            where: { id: existing.id },
+            data: {
+              title,
+              treatmentAt: appointment.startAt,
+              patientId: appointment.patientId,
+              providerUserId: appointment.providerUserId,
+              status: TreatmentStatus.DRAFT,
+            },
+          })
+        : await tx.treatment.create({
+            data: {
+              organizationId,
+              patientId: appointment.patientId,
+              appointmentId: appointment.id,
+              providerUserId: appointment.providerUserId,
+              title,
+              status: TreatmentStatus.DRAFT,
+              treatmentAt: appointment.startAt,
+            },
+          });
+
+      const keepCaseIds = normalizedCases.map((c) => c.id).filter(Boolean) as string[];
+      const existingCases = existing
+        ? await tx.treatmentCase.findMany({
+            where: { treatmentId: saved.id },
+            select: { id: true, sentAt: true },
+          })
+        : [];
+
+      const sentCaseIds = new Set(
+        existingCases.filter((c) => c.sentAt).map((c) => c.id),
+      );
+
+      const removableCaseIds = existingCases
+        .filter((c) => !keepCaseIds.includes(c.id) && !c.sentAt)
+        .map((c) => c.id);
+
+      if (removableCaseIds.length > 0) {
+        await tx.treatmentCase.deleteMany({
+          where: { id: { in: removableCaseIds }, treatmentId: saved.id },
+        });
+      }
+
+      for (const c of normalizedCases) {
+        if (c.id && sentCaseIds.has(c.id)) {
+          continue;
+        }
+
+        const row = c.id
+          ? await tx.treatmentCase.update({
+              where: { id: c.id },
+              data: {
+                clientKey: c.clientId,
+                sortOrder: c.sortOrder,
+                treatmentType: c.treatmentType,
+                teeth: c.teeth,
+                comment: c.comment,
+              },
+            })
+          : await tx.treatmentCase.create({
+              data: {
+                treatmentId: saved.id,
+                clientKey: c.clientId,
+                sortOrder: c.sortOrder,
+                treatmentType: c.treatmentType,
+                teeth: c.teeth,
+                comment: c.comment,
+              },
+            });
+
+        const allowedAttachmentIds = new Set(c.attachmentIds);
+        const pendingAttachments = await tx.treatmentCaseAttachment.findMany({
+          where: {
+            appointmentId: appointment.id,
+            caseClientKey: c.clientId,
+          },
+        });
+
+        for (const attachment of pendingAttachments) {
+          if (!allowedAttachmentIds.has(attachment.id)) {
+            await tx.treatmentCaseAttachment.delete({ where: { id: attachment.id } });
+          } else {
+            await tx.treatmentCaseAttachment.update({
+              where: { id: attachment.id },
+              data: { caseId: row.id, appointmentId: null, caseClientKey: null },
+            });
+          }
+        }
+
+        await tx.treatmentCaseAttachment.deleteMany({
+          where: {
+            caseId: row.id,
+            id: { notIn: [...allowedAttachmentIds] },
+          },
+        });
+      }
+
+      return tx.treatment.findUniqueOrThrow({
+        where: { id: saved.id },
+        include: treatmentInclude,
+      });
+    });
+
+    return { success: true, data: this.mapTreatment(treatment) };
+  }
+
+  async sendCase(
+    caseId: string,
+    dto: SendTreatmentCaseDto,
+    organizationId: string,
+    actorUserId: string,
+  ) {
+    await this.assertCanEditTreatment(actorUserId, organizationId);
+
+    const treatmentCase = await this.prisma.treatmentCase.findFirst({
+      where: {
+        id: caseId,
+        treatment: { organizationId },
+      },
+      include: {
+        treatment: { select: { providerUserId: true, appointmentId: true } },
+        sends: { select: { organizationId: true } },
+      },
+    });
+
+    if (!treatmentCase) {
+      throw new NotFoundException('Treatment case not found');
+    }
+
+    if (treatmentCase.treatment.providerUserId !== actorUserId) {
+      const membership = await this.getMembership(actorUserId, organizationId);
+      if (!membership?.isOwner) {
+        throw new ForbiddenException('Only the appointment provider can send this case');
+      }
+    }
+
+    const linkedOrgIds = await this.getActiveLinkedOrganizationIds(organizationId);
+    const uniqueTargets = [...new Set(dto.organizationIds)];
+
+    for (const orgId of uniqueTargets) {
+      if (!linkedOrgIds.has(orgId)) {
+        throw new BadRequestException('One or more organizations are not active linked counterparts');
+      }
+    }
+
+    const alreadySent = new Set(treatmentCase.sends.map((s) => s.organizationId));
+    const newTargets = uniqueTargets.filter((id) => !alreadySent.has(id));
+
+    if (newTargets.length === 0) {
+      throw new BadRequestException('Case was already sent to all selected organizations');
+    }
+
+    const now = new Date();
+
+    await this.prisma.$transaction(async (tx) => {
+      await tx.treatmentCaseSend.createMany({
+        data: newTargets.map((organizationId) => ({
+          caseId,
+          organizationId,
+        })),
+      });
+
+      if (!treatmentCase.sentAt) {
+        await tx.treatmentCase.update({
+          where: { id: caseId },
+          data: { sentAt: now },
+        });
+      }
+    });
+
+    const refreshed = await this.prisma.treatmentCase.findUniqueOrThrow({
+      where: { id: caseId },
+      include: {
+        attachments: { orderBy: [{ createdAt: 'asc' }] },
+        sends: {
+          orderBy: [{ sentAt: 'asc' }],
+          include: { organization: { select: { id: true, name: true } } },
+        },
+      },
+    });
+
+    return { success: true, data: this.mapCase(refreshed) };
+  }
+
+  async uploadCaseAttachments(
+    appointmentId: string,
+    caseClientKey: string,
+    files: Express.Multer.File[],
+    organizationId: string,
+    actorUserId: string,
+  ) {
+    await this.assertCanEditTreatment(actorUserId, organizationId);
+    await this.ensureAppointmentProvider(appointmentId, organizationId, actorUserId, true);
+
+    if (!caseClientKey?.trim()) {
+      throw new BadRequestException('caseClientKey is required');
+    }
+
+    if (!files?.length) {
+      throw new BadRequestException('At least one file is required');
+    }
+
+    const orgDir = join(this.uploadRoot, organizationId);
+    mkdirSync(orgDir, { recursive: true });
+
+    const created: {
+      id: string;
+      fileName: string;
+      mimeType: string;
+      sizeBytes: number;
+    }[] = [];
+
+    for (const file of files) {
+      const storageName = `${randomUUID()}-${file.originalname.replace(/[^\w.\-()+]/g, '_')}`;
+      const storagePath = join(orgDir, storageName);
+      const { writeFileSync } = await import('fs');
+      writeFileSync(storagePath, file.buffer);
+
+      const attachment = await this.prisma.treatmentCaseAttachment.create({
+        data: {
+          appointmentId,
+          caseClientKey,
+          fileName: file.originalname,
+          mimeType: file.mimetype || 'application/octet-stream',
+          sizeBytes: file.size,
+          storagePath,
+        },
+      });
+
+      created.push(this.mapAttachment(attachment));
+    }
+
+    return { success: true, data: created };
+  }
+
+  async streamAttachmentFile(
+    attachmentId: string,
+    organizationId: string,
+    actorUserId: string,
+  ) {
+    await this.assertCanReadTreatment(actorUserId, organizationId);
+
+    const attachment = await this.prisma.treatmentCaseAttachment.findFirst({
+      where: {
+        id: attachmentId,
+        OR: [
+          { case: { treatment: { organizationId } } },
+          { appointmentId: { not: null } },
+        ],
+      },
+      include: {
+        case: { select: { treatment: { select: { organizationId: true } } } },
+      },
+    });
+
+    if (!attachment) {
+      throw new NotFoundException('Attachment not found');
+    }
+
+    if (attachment.case && attachment.case.treatment.organizationId !== organizationId) {
+      throw new NotFoundException('Attachment not found');
+    }
+
+    if (!attachment.case && attachment.appointmentId) {
+      const appointment = await this.prisma.appointment.findFirst({
+        where: { id: attachment.appointmentId, organizationId },
+        select: { id: true },
+      });
+      if (!appointment) {
+        throw new NotFoundException('Attachment not found');
+      }
+    }
+
+    if (!existsSync(attachment.storagePath)) {
+      throw new NotFoundException('File is no longer available');
+    }
+
+    return {
+      stream: createReadStream(attachment.storagePath),
+      fileName: attachment.fileName,
+      mimeType: attachment.mimeType,
+    };
+  }
+
+  private mapTreatment(treatment: {
+    id: string;
+    patientId: string;
+    appointmentId: string | null;
+    title: string;
+    status: TreatmentStatus;
+    treatmentAt: Date;
+    cases: Array<{
+      id: string;
+      clientKey: string | null;
+      treatmentType: string;
+      teeth: unknown;
+      comment: string | null;
+      sentAt: Date | null;
+      attachments: Array<{
+        id: string;
+        fileName: string;
+        mimeType: string;
+        sizeBytes: number;
+      }>;
+      sends: Array<{ organizationId: string; sentAt: Date; organization: { id: string; name: string } }>;
+    }>;
+  }) {
+    const documents = treatment.cases.flatMap((c) =>
+      c.attachments.map((a) => this.mapAttachment(a)),
+    );
+
+    return {
+      id: treatment.id,
+      patientId: treatment.patientId,
+      appointmentId: treatment.appointmentId,
+      title: treatment.title,
+      treatmentAt: treatment.treatmentAt.toISOString(),
+      status: mapTreatmentStatusForApi(treatment.status),
+      cases: treatment.cases.map((c) => this.mapCase(c)),
+      documents,
+    };
+  }
+
+  private mapCase(c: {
+    id: string;
+    clientKey?: string | null;
+    treatmentType: string;
+    teeth: unknown;
+    comment?: string | null;
+    sentAt?: Date | null;
+    attachments?: Array<{
+      id: string;
+      fileName: string;
+      mimeType: string;
+      sizeBytes: number;
+    }>;
+    sends?: Array<{ organizationId: string; sentAt: Date; organization?: { id: string; name: string } }>;
+  }) {
+    return {
+      id: c.id,
+      clientId: c.clientKey ?? c.id,
+      treatmentType: c.treatmentType,
+      teeth: normalizeTeeth(c.teeth),
+      notes: c.comment ?? null,
+      sentAt: c.sentAt?.toISOString() ?? null,
+      sendToOrganizationIds: c.sends?.map((s) => s.organizationId) ?? [],
+      sends:
+        c.sends?.map((s) => ({
+          organizationId: s.organizationId,
+          organizationName: s.organization?.name ?? 'Unknown organization',
+          sentAt: s.sentAt.toISOString(),
+        })) ?? [],
+      attachmentMetas: (c.attachments ?? []).map((a) => this.mapAttachment(a)),
+    };
+  }
+
+  private mapAttachment(a: {
+    id: string;
+    fileName: string;
+    mimeType: string;
+    sizeBytes: number;
+  }) {
+    return {
+      id: a.id,
+      fileName: a.fileName,
+      mimeType: a.mimeType,
+      sizeBytes: a.sizeBytes,
+    };
+  }
+
+  private async getActiveLinkedOrganizationIds(organizationId: string) {
+    const [linksA, linksB] = await Promise.all([
+      this.prisma.organizationLink.findMany({
+        where: { organizationAId: organizationId, status: LinkStatus.ACTIVE },
+        select: { organizationBId: true },
+      }),
+      this.prisma.organizationLink.findMany({
+        where: { organizationBId: organizationId, status: LinkStatus.ACTIVE },
+        select: { organizationAId: true },
+      }),
+    ]);
+
+    return new Set([
+      ...linksA.map((l) => l.organizationBId),
+      ...linksB.map((l) => l.organizationAId),
+    ]);
+  }
+
+  private async ensurePatientInOrg(patientId: string, organizationId: string) {
+    const patient = await this.prisma.patient.findFirst({
+      where: { id: patientId, organizationId },
+      select: { id: true },
+    });
+    if (!patient) {
+      throw new NotFoundException('Patient not found');
+    }
+  }
+
+  private async ensureAppointmentProvider(
+    appointmentId: string,
+    organizationId: string,
+    actorUserId: string,
+    requireProviderMatch: boolean,
+  ) {
+    const appointment = await this.prisma.appointment.findFirst({
+      where: { id: appointmentId, organizationId },
+      select: {
+        id: true,
+        patientId: true,
+        providerUserId: true,
+        startAt: true,
+      },
+    });
+
+    if (!appointment) {
+      throw new NotFoundException('Appointment not found');
+    }
+
+    if (requireProviderMatch) {
+      const membership = await this.getMembership(actorUserId, organizationId);
+      const isOwner = membership?.isOwner ?? false;
+      if (!isOwner && appointment.providerUserId !== actorUserId) {
+        throw new ForbiddenException('You are not the provider for this appointment');
+      }
+    }
+
+    return appointment;
+  }
+
+  private async assertCanReadTreatment(userId: string, organizationId: string) {
+    const m = await this.getMembership(userId, organizationId);
+    if (!m) {
+      throw new ForbiddenException('You are not a member of this organization');
+    }
+    if (m.isOwner) return;
+    const names = m.permissions.map((p) => p.permission.name);
+    if (names.includes('TAB_TREATMENT_READ') || names.includes('TAB_TREATMENT_EDIT')) {
+      return;
+    }
+    throw new ForbiddenException('You do not have access to treatments');
+  }
+
+  private async assertCanEditTreatment(userId: string, organizationId: string) {
+    const m = await this.getMembership(userId, organizationId);
+    if (!m) {
+      throw new ForbiddenException('You are not a member of this organization');
+    }
+    if (m.isOwner) return;
+    const names = m.permissions.map((p) => p.permission.name);
+    if (names.includes('TAB_TREATMENT_EDIT')) {
+      return;
+    }
+    throw new ForbiddenException('You cannot edit treatments');
+  }
+
+  private async getMembership(userId: string, organizationId: string) {
+    return this.prisma.membership.findFirst({
+      where: { userId, organizationId, isActive: true },
+      include: { permissions: { include: { permission: true } } },
+    });
+  }
+}
--- a/frontend/src/app/(dashboard)/patients/page.tsx
+++ b/frontend/src/app/(dashboard)/patients/page.tsx
@@ -8,16 +8,10 @@ import { formatApiErrorMessage } from '@/components/shared/formatApiError';
 import { useAuth } from '@/lib/hooks/useAuth';
 import { useToast } from '@/lib/hooks/useToast';
 import { hasPermission } from '@/components/shared/permissions';
-import {
-  CreatePatientInput,
-  CreateTreatmentHistoryInput,
-  Patient,
-  TreatmentHistoryItem,
-} from '@/types/patient';
+import { CreatePatientInput, Patient } from '@/types/patient';
 import { PatientSearchSelect } from '../../../components/ui/patient/PatientSearchSelect';
 import { CreatePatientModal } from '../../../components/ui/patient/CreatePatientModal';
 import { PatientSummaryCard } from '../../../components/ui/patient/PatientSummaryCard';
-import { TreatmentHistoryPreview } from '../../../components/ui/patient/TreatmentHistoryPreview';

 const EMPTY_PATIENT_FORM: CreatePatientInput = {
  firstName: '',
@@ -32,12 +26,9 @@ export default function PatientsPage() {
  const [search, setSearch] = useState('');
  const [patients, setPatients] = useState<Patient[]>([]);
  const [selectedPatient, setSelectedPatient] = useState<Patient | undefined>();
-  const [treatments, setTreatments] = useState<TreatmentHistoryItem[]>([]);
  const [loadingPatients, setLoadingPatients] = useState(false);
-  const [loadingTreatments, setLoadingTreatments] = useState(false);
  const [isCreateOpen, setIsCreateOpen] = useState(false);
  const [savingPatient, setSavingPatient] = useState(false);
-  const [savingTreatment, setSavingTreatment] = useState(false);
  const [patientForm, setPatientForm] = useState<CreatePatientInput>(EMPTY_PATIENT_FORM);
  const canEditPatients = hasPermission(currentOrganization, 'TAB_PATIENTS_EDIT');

@@ -79,19 +70,6 @@ export default function PatientsPage() {
    }
  }

-  async function loadTreatments(patientId: string) {
-    setLoadingTreatments(true);
-    toast.setError('');
-    try {
-      const response = await patientsApi.listTreatments(patientId);
-      setTreatments(response.data);
-    } catch (error: unknown) {
-      toast.showError(formatApiErrorMessage(error, 'Failed to load treatment history.'));
-    } finally {
-      setLoadingTreatments(false);
-    }
-  }
-
  async function handleCreatePatient() {
    setSavingPatient(true);
    toast.setError('');
@@ -101,7 +79,6 @@ export default function PatientsPage() {
      setPatientForm(EMPTY_PATIENT_FORM);
      await loadPatients(search);
      setSelectedPatient(response.data);
-      await loadTreatments(response.data.id);
      toast.showSuccess(
        `Patient ${response.data.firstName} ${response.data.lastName} was saved successfully.`,
      );
@@ -112,31 +89,6 @@ export default function PatientsPage() {
    }
  }

-  async function handleQuickAddTreatment() {
-    if (!selectedPatient) {
-      return;
-    }
-
-    const payload: CreateTreatmentHistoryInput = {
-      title: 'Initial consultation',
-      status: 'scheduled',
-      treatmentAt: new Date().toISOString(),
-      notes: 'Created from quick action on patients page.',
-    };
-
-    setSavingTreatment(true);
-    toast.setError('');
-    try {
-      await patientsApi.addTreatment(selectedPatient.id, payload);
-      await loadTreatments(selectedPatient.id);
-      toast.showSuccess('Treatment entry added successfully.');
-    } catch (error: unknown) {
-      toast.showError(formatApiErrorMessage(error, 'Failed to add treatment entry.'));
-    } finally {
-      setSavingTreatment(false);
-    }
-  }
-
  return (
    <div className="space-y-6">
      <div className="flex items-center justify-between gap-3">
@@ -179,31 +131,13 @@ export default function PatientsPage() {
            onSearchChange={setSearch}
            patients={sortedPatients}
            selectedPatientId={selectedPatient?.id}
-            onSelectPatient={(patient) => {
-              setSelectedPatient(patient);
-              void loadTreatments(patient.id);
-            }}
+            onSelectPatient={setSelectedPatient}
            loading={loadingPatients}
          />
        </div>

        <div className="xl:col-span-2 space-y-4">
          <PatientSummaryCard patient={selectedPatient} />
-          <div className="flex">
-            <Button
-              variant="secondary"
-              disabled={!selectedPatient || !canEditPatients}
-              isLoading={savingTreatment}
-              onClick={() => {
-                if (!canEditPatients) return;
-                void handleQuickAddTreatment();
-              }}
-              title={!canEditPatients ? 'Read-only access for this organization.' : undefined}
-            >
-              Add Quick Treatment Entry
-            </Button>
-          </div>
-          <TreatmentHistoryPreview items={treatments} loading={loadingTreatments} />
        </div>
      </div>
    </div>
--- a/frontend/src/components/shared/permissions.ts
+++ b/frontend/src/components/shared/permissions.ts
@@ -82,7 +82,8 @@ export function canAccessAppointmentsSection(org: Organization | null): boolean
  return (
    hasPermission(org, 'TAB_APPOINTMENTS_READ') ||
    hasPermission(org, 'TAB_APPOINTMENTS_EDIT') ||
-    hasPermission(org, 'TAB_TREATMENT_EDIT')
+    hasPermission(org, 'TAB_TREATMENT_EDIT') ||
+    hasPermission(org, 'TAB_TREATMENT_READ')
  );
 }

@@ -92,3 +93,13 @@ export function canEditTreatment(org: Organization | null): boolean {
  if (org.isOwner) return true;
  return hasPermission(org, 'TAB_TREATMENT_EDIT');
 }
+
+/** View treatment workspace (read-only or edit) */
+export function canViewTreatment(org: Organization | null): boolean {
+  if (!org) return false;
+  if (org.isOwner) return true;
+  return (
+    hasPermission(org, 'TAB_TREATMENT_READ') ||
+    hasPermission(org, 'TAB_TREATMENT_EDIT')
+  );
+}
--- a/frontend/src/components/treatment/caseSendLabel.ts
+++ b/frontend/src/components/treatment/caseSendLabel.ts
@@ -0,0 +1,40 @@
+import type { LinkedOrganizationOption, TreatmentCaseSendInfo } from '@/types/treatment';
+
+export function formatCaseSentLines(
+  sends: TreatmentCaseSendInfo[] | undefined,
+  fallback?: {
+    organizationIds: string[];
+    sentAt: string | null;
+    orgs?: LinkedOrganizationOption[];
+  },
+): string[] {
+  if (sends?.length) {
+    return sends.map((s) => {
+      const at = new Date(s.sentAt).toLocaleString();
+      return `Sent to ${s.organizationName} at ${at}`;
+    });
+  }
+
+  if (fallback?.sentAt && fallback.organizationIds.length > 0) {
+    const at = new Date(fallback.sentAt).toLocaleString();
+    const nameById = new Map(fallback.orgs?.map((o) => [o.id, o.name]) ?? []);
+    return fallback.organizationIds.map((id) => {
+      const name = nameById.get(id) ?? 'organization';
+      return `Sent to ${name} at ${at}`;
+    });
+  }
+
+  return [];
+}
+
+export function formatCaseSentSummary(
+  sends: TreatmentCaseSendInfo[] | undefined,
+  fallback?: {
+    organizationIds: string[];
+    sentAt: string | null;
+    orgs?: LinkedOrganizationOption[];
+  },
+): string | null {
+  const lines = formatCaseSentLines(sends, fallback);
+  return lines.length > 0 ? lines.join(' · ') : null;
+}
--- a/frontend/src/components/ui/patient/TreatmentHistoryPreview.tsx
+++ b/frontend/src/components/ui/patient/TreatmentHistoryPreview.tsx
@@ -1,37 +0,0 @@
-import { TreatmentHistoryItem } from '@/types/patient';
-
-interface TreatmentHistoryPreviewProps {
-  items: TreatmentHistoryItem[];
-  loading?: boolean;
-}
-
-export function TreatmentHistoryPreview({ items, loading = false }: TreatmentHistoryPreviewProps) {
-  return (
-    <div className="surface-card p-4 space-y-3">
-      <h3 className="text-base font-semibold text-text-primary">Treatment History</h3>
-
-      {loading && <p className="text-sm text-text-muted">Loading treatment history...</p>}
-
-      {!loading && items.length === 0 && (
-        <p className="text-sm text-text-muted">No treatment history yet.</p>
-      )}
-
-      <div className="space-y-2">
-        {items.map((item) => (
-          <div key={item.id} className="border border-border/60 rounded-[var(--radius-sm)] p-3">
-            <div className="flex items-center justify-between">
-              <p className="text-sm font-medium text-text-primary">{item.title}</p>
-              <p className="text-xs text-text-muted">
-                {new Date(item.treatmentAt).toLocaleDateString()}
-              </p>
-            </div>
-            <p className="text-xs text-text-secondary mt-1">
-              Status: {item.status}
-              {item.tooth ? ` | Tooth: ${item.tooth}` : ''}
-            </p>
-          </div>
-        ))}
-      </div>
-    </div>
-  );
-}
--- a/frontend/src/components/ui/treatment/CaseLatestAttachmentPreview.tsx
+++ b/frontend/src/components/ui/treatment/CaseLatestAttachmentPreview.tsx
@@ -0,0 +1,72 @@
+'use client';
+
+import { useEffect, useState } from 'react';
+import { FileText } from 'lucide-react';
+import { treatmentsApi } from '@/lib/api/treatments';
+import type { TreatmentAttachmentMeta } from '@/types/treatment';
+
+interface CaseLatestAttachmentPreviewProps {
+  attachment: TreatmentAttachmentMeta;
+  className?: string;
+}
+
+export function CaseLatestAttachmentPreview({
+  attachment,
+  className = 'aspect-square w-full max-w-[11rem]',
+}: CaseLatestAttachmentPreviewProps) {
+  const [url, setUrl] = useState<string | null>(null);
+  const [failed, setFailed] = useState(false);
+
+  useEffect(() => {
+    let cancelled = false;
+    let objectUrl: string | null = null;
+
+    void (async () => {
+      try {
+        const blob = await treatmentsApi.getAttachmentFileBlob(attachment.id);
+        if (cancelled) return;
+        objectUrl = URL.createObjectURL(blob);
+        setUrl(objectUrl);
+        setFailed(false);
+      } catch {
+        if (!cancelled) setFailed(true);
+      }
+    })();
+
+    return () => {
+      cancelled = true;
+      if (objectUrl) URL.revokeObjectURL(objectUrl);
+    };
+  }, [attachment.id]);
+
+  const isImage = attachment.mimeType.startsWith('image/');
+  const isPdf = attachment.mimeType === 'application/pdf';
+
+  return (
+    <div
+      className={`${className} rounded-[var(--radius-md)] border border-border/60 bg-background-secondary overflow-hidden`}
+      title={attachment.fileName}
+    >
+      {url && isImage ? (
+        <img
+          src={url}
+          alt={attachment.fileName}
+          className="h-full w-full object-fill"
+        />
+      ) : url && isPdf ? (
+        <iframe
+          src={url}
+          title={attachment.fileName}
+          className="h-full w-full border-0"
+        />
+      ) : (
+        <div className="flex h-full w-full flex-col items-center justify-center gap-1.5 p-2 text-text-muted">
+          <FileText className="h-8 w-8 shrink-0 icon-flat" aria-hidden />
+          <span className="line-clamp-2 text-center text-[10px] leading-tight">
+            {failed ? 'Preview unavailable' : attachment.fileName}
+          </span>
+        </div>
+      )}
+    </div>
+  );
+}
--- a/frontend/src/components/ui/treatment/CaseSentLabel.tsx
+++ b/frontend/src/components/ui/treatment/CaseSentLabel.tsx
@@ -0,0 +1,31 @@
+import { formatCaseSentLines } from '@/components/treatment/caseSendLabel';
+import type { LinkedOrganizationOption, PastTreatmentCase, TreatmentCaseDraft } from '@/types/treatment';
+
+interface CaseSentLabelProps {
+  treatmentCase: Pick<
+    PastTreatmentCase | TreatmentCaseDraft,
+    'sends' | 'sendToOrganizationIds' | 'sentAt'
+  >;
+  orgs?: LinkedOrganizationOption[];
+  className?: string;
+}
+
+export function CaseSentLabel({ treatmentCase, orgs, className = 'text-xs text-text-muted' }: CaseSentLabelProps) {
+  const lines = formatCaseSentLines(treatmentCase.sends, {
+    organizationIds: treatmentCase.sendToOrganizationIds ?? [],
+    sentAt: treatmentCase.sentAt ?? null,
+    orgs,
+  });
+
+  if (lines.length === 0) return null;
+
+  return (
+    <div className={className}>
+      {lines.map((line, i) => (
+        <span key={`${line}-${i}`} className="block">
+          {line}
+        </span>
+      ))}
+    </div>
+  );
+}
--- a/frontend/src/components/ui/treatment/FdiToothChart.tsx
+++ b/frontend/src/components/ui/treatment/FdiToothChart.tsx
@@ -103,7 +103,7 @@ export function FdiToothChart({ selected, onToggle, disabled }: FdiToothChartPro
  };

  const Row = ({ teeth, upper }: { teeth: FdiToothId[]; upper?: boolean }) => (
-    <div className="flex flex-wrap justify-center gap-x-1 gap-y-1">
+    <div className="flex flex-nowrap justify-center gap-x-1 min-w-max mx-auto w-fit">
      {teeth.map((fdi, i) => {
        const kind = getToothShapeKind(fdi);
        const gid = `${uid}-g-${fdi}-${i}`;
@@ -148,31 +148,30 @@ export function FdiToothChart({ selected, onToggle, disabled }: FdiToothChartPro
  );

  return (
-    <div className="surface-card p-4 space-y-6">
-      <div className="flex flex-col gap-3 sm:flex-row sm:items-start sm:justify-between">
+    <div className="surface-card p-3 space-y-3">
+      <div className="flex flex-col gap-1.5 sm:flex-row sm:items-center sm:justify-between">
        <div>
          <h3 className="text-sm font-semibold text-text-primary">FDI tooth chart</h3>
-          <p className="text-xs text-text-muted mt-0.5">
-            Tap teeth to multi-select (FDI). Selection applies to the active treatment record until you save.
+          <p className="text-[11px] text-text-muted mt-0.5">
+            Tap teeth to multi-select. Applies to the active case.
          </p>
        </div>
-        <div className="flex flex-col gap-2 sm:items-end w-full sm:max-w-xs">
-          <p className="text-xs text-text-secondary tabular-nums text-right">
+        <p className="text-[11px] text-text-secondary tabular-nums sm:text-right">
          Selected: {selected.size === 0 ? '—' : [...selected].sort().join(', ')}
        </p>
      </div>
-      </div>

      <p className="text-[11px] uppercase tracking-wide text-text-muted mb-1 text-center">Upper arch</p>

-      <div className="relative isolate py-1">
+      <div className="overflow-x-auto py-1 -mx-1 px-1">
+        <div className="relative isolate min-w-max mx-auto w-fit">
          <div
            className="pointer-events-none absolute left-1/2 top-3 bottom-3 w-px -translate-x-1/2 bg-border/70"
            aria-hidden
          />
          <div className="relative z-10 space-y-0">
            <Row teeth={FDI_UPPER_LEFT_TO_RIGHT} upper />
-          <div className={`flex justify-center gap-x-1 ${TOOTH_NUMBER_GAP}`}>
+            <div className={`flex flex-nowrap justify-center gap-x-1 ${TOOTH_NUMBER_GAP}`}>
              {FDI_UPPER_LEFT_TO_RIGHT.map((fdi) => {
                const size = toothSizeClass(fdi);
                const isSel = selected.has(fdi);
@@ -189,14 +188,10 @@ export function FdiToothChart({ selected, onToggle, disabled }: FdiToothChartPro
              })}
            </div>

-          <div
-            className="my-4 h-px w-full max-w-[min(100%,42rem)] mx-auto bg-border/70"
-            role="separator"
-            aria-hidden
-          />
+            <div className="my-2 h-px w-full bg-border/70" role="separator" aria-hidden />

-          <div className="my-4 pt-1">
-            <div className="flex justify-center gap-x-1">
+            <div className="pt-0.5">
+              <div className="flex flex-nowrap justify-center gap-x-1">
                {FDI_LOWER_LEFT_TO_RIGHT.map((fdi) => {
                  const size = toothSizeClass(fdi);
                  const isSel = selected.has(fdi);
@@ -218,6 +213,7 @@ export function FdiToothChart({ selected, onToggle, disabled }: FdiToothChartPro
            </div>
          </div>
        </div>
+      </div>

      <p className="text-[11px] uppercase tracking-wide text-text-muted mt-1 text-center">Lower arch</p>
    </div>
--- a/frontend/src/components/ui/treatment/PastTreatmentsPanel.tsx
+++ b/frontend/src/components/ui/treatment/PastTreatmentsPanel.tsx
@@ -2,89 +2,92 @@

 import { FileText } from 'lucide-react';
 import type { PastTreatment } from '@/types/treatment';
+import { CaseSentLabel } from '@/components/ui/treatment/CaseSentLabel';

 interface PastTreatmentsPanelProps {
  items: PastTreatment[];
  loading?: boolean;
-  selectedTreatmentId?: string | null;
-  onSelectTreatment?: (treatment: PastTreatment) => void;
+  onReviewTreatment?: (treatment: PastTreatment) => void;
 }

 export function PastTreatmentsPanel({
  items,
  loading,
-  selectedTreatmentId,
-  onSelectTreatment,
+  onReviewTreatment,
 }: PastTreatmentsPanelProps) {
  return (
    <div className="surface-card p-4 space-y-3">
      <div>
        <h3 className="text-sm font-semibold text-text-primary">Previous treatments</h3>
-        <p className="text-xs text-text-muted mt-0.5">
-          Document preview is not implemented yet; file names are listed for context.
+        <p className="text-[11px] text-text-muted mt-0.5">
+          Completed treatments for this patient. Each case is listed separately.
        </p>
      </div>

-      {loading && <p className="text-sm text-text-muted">Loading history...</p>}
+      {loading && <p className="text-sm text-text-muted">Loading history…</p>}

      {!loading && items.length === 0 && (
        <p className="text-sm text-text-muted">No prior treatments for this patient.</p>
      )}

-      <div className="space-y-3 max-h-[min(420px,55vh)] overflow-y-auto pr-1">
+      <div className="space-y-3 max-h-[min(420px,50vh)] overflow-y-auto pr-1">
        {items.map((t) => (
          <article
            key={t.id}
-            className={`border rounded-[var(--radius-md)] p-3 ${
-              selectedTreatmentId === t.id
-                ? 'border-primary/70 bg-primary-soft/35'
-                : 'border-border/70 bg-background-secondary/40'
-            }`}
+            className="border border-border/70 rounded-[var(--radius-md)] p-2.5 bg-background-secondary/40 space-y-2"
          >
            <div className="flex items-start justify-between gap-2">
-              <p className="text-sm font-medium text-text-primary">{t.title}</p>
-              <time className="text-xs text-text-muted tabular-nums shrink-0" dateTime={t.treatmentAt}>
+              <div className="min-w-0">
+                <p className="text-sm font-medium text-text-primary truncate">{t.title}</p>
+                <p className="text-[11px] text-text-secondary capitalize mt-0.5">Status: {t.status}</p>
+              </div>
+              <time
+                className="text-[11px] text-text-muted tabular-nums shrink-0"
+                dateTime={t.treatmentAt}
+              >
                {new Date(t.treatmentAt).toLocaleDateString()}
              </time>
            </div>
-            <p className="text-xs text-text-secondary mt-1">Status: {t.status}</p>

-            {t.records.length > 0 && (
-              <ul className="mt-2 space-y-1.5 text-xs text-text-secondary">
-                {t.records.map((r) => (
-                  <li key={r.id}>
-                    <span className="text-text-primary font-medium">Record: </span>
-                    <span className="capitalize">{r.treatmentType}</span>
-                    {' | '}
-                    {r.teeth.length > 0 ? `Teeth ${[...r.teeth].sort().join(', ')}` : 'No teeth tagged'}
-                    {r.notes ? ` — ${r.notes}` : ''}
-                  </li>
-                ))}
-              </ul>
-            )}
-
-            {onSelectTreatment && (
-              <div className="mt-3 pt-2 border-t border-border/50 flex justify-end">
-                <button
-                  type="button"
-                  onClick={() => onSelectTreatment(t)}
-                  className="text-xs text-primary hover:underline focus:outline-none focus-visible:ring-2 focus-visible:ring-primary/35 rounded-[var(--radius-sm)] px-1"
+            <div className="space-y-1.5">
+              {t.cases.map((c, idx) => {
+                const attachments = c.attachmentMetas ?? [];
+                return (
+                  <div
+                    key={c.id}
+                    className="border border-border/60 rounded-[var(--radius-sm)] px-2.5 py-2 bg-background-secondary/30 space-y-1"
                  >
-                  Review details
-                </button>
-              </div>
+                    <div className="flex items-center justify-between gap-2">
+                      <p className="text-xs font-medium text-text-primary capitalize">
+                        Case {idx + 1} · {c.treatmentType}
+                      </p>
+                      {c.sentAt && (
+                        <CaseSentLabel
+                          treatmentCase={c}
+                          className="text-[10px] text-text-muted shrink-0 text-right"
+                        />
                      )}
-
-            {t.documents.length > 0 && (
-              <div className="mt-3 pt-2 border-t border-border/50">
-                <p className="text-[11px] uppercase tracking-wide text-text-muted mb-1.5">Attachments</p>
-                <ul className="space-y-1">
-                  {t.documents.map((doc) => (
+                    </div>
+                    <p className="text-[11px] text-text-secondary">
+                      Teeth: {c.teeth.length ? [...c.teeth].sort().join(', ') : 'None selected'}
+                    </p>
+                    {c.notes?.trim() && (
+                      <p className="text-[11px] text-text-muted line-clamp-2">{c.notes}</p>
+                    )}
+                    <div>
+                      <p className="text-[10px] uppercase tracking-wide text-text-muted mb-1">
+                        Attachments
+                      </p>
+                      {attachments.length === 0 ? (
+                        <p className="text-[11px] text-text-muted">None</p>
+                      ) : (
+                        <ul className="space-y-0.5">
+                          {attachments.map((doc) => (
                            <li
                              key={doc.id}
-                      className="flex items-center gap-2 text-xs text-text-secondary"
+                              className="flex items-center gap-1.5 text-[11px] text-text-secondary"
                            >
-                      <FileText className="w-3.5 h-3.5 shrink-0 icon-flat" aria-hidden />
+                              <FileText className="w-3 h-3 shrink-0 icon-flat" aria-hidden />
                              <span className="truncate">{doc.fileName}</span>
                              <span className="text-text-muted tabular-nums shrink-0">
                                {(doc.sizeBytes / 1024).toFixed(1)} KB
@@ -92,6 +95,22 @@ export function PastTreatmentsPanel({
                            </li>
                          ))}
                        </ul>
+                      )}
+                    </div>
+                  </div>
+                );
+              })}
+            </div>
+
+            {onReviewTreatment && (
+              <div className="pt-1 flex justify-end">
+                <button
+                  type="button"
+                  onClick={() => onReviewTreatment(t)}
+                  className="text-xs text-primary hover:underline focus:outline-none focus-visible:ring-2 focus-visible:ring-primary/35 rounded-[var(--radius-sm)] px-1"
+                >
+                  Review details
+                </button>
              </div>
            )}
          </article>
--- a/frontend/src/components/ui/treatment/TreatmentCasesEditor.tsx
+++ b/frontend/src/components/ui/treatment/TreatmentCasesEditor.tsx
@@ -0,0 +1,296 @@
+'use client';
+
+import { useRef } from 'react';
+import { Button } from '@/components/ui/shared/Button';
+import { Checkbox } from '@/components/ui/shared/Checkbox';
+import { Dropdown } from '@/components/ui/shared/Dropdown';
+import { SearchBar } from '@/components/ui/shared/SearchBar';
+import type { LinkedOrganizationOption, TreatmentCaseDraft } from '@/types/treatment';
+import { formatCaseSentSummary } from '@/components/treatment/caseSendLabel';
+import { CaseSentLabel } from '@/components/ui/treatment/CaseSentLabel';
+
+interface TreatmentCasesEditorProps {
+  cases: TreatmentCaseDraft[];
+  activeCaseId: string;
+  onActiveCaseChange: (id: string) => void;
+  onCasesChange: (cases: TreatmentCaseDraft[]) => void;
+  disabled: boolean;
+  canEdit: boolean;
+  isDirty: boolean;
+  saveBusy: boolean;
+  sendBusyId: string | null;
+  uploadBusy: boolean;
+  orgs: LinkedOrganizationOption[];
+  organizationSearch: string;
+  onOrganizationSearchChange: (value: string) => void;
+  recentOrganizationIds: string[];
+  onRecentOrganizationPick: (orgId: string) => void;
+  onAddCase: () => void;
+  onPreview: () => void;
+  onSave: () => void;
+  onSendCase: (c: TreatmentCaseDraft) => void;
+  onUploadFiles: (files: FileList | null) => void;
+}
+
+export function TreatmentCasesEditor({
+  cases,
+  activeCaseId,
+  onActiveCaseChange,
+  onCasesChange,
+  disabled,
+  canEdit,
+  isDirty,
+  saveBusy,
+  sendBusyId,
+  uploadBusy,
+  orgs,
+  organizationSearch,
+  onOrganizationSearchChange,
+  recentOrganizationIds,
+  onRecentOrganizationPick,
+  onAddCase,
+  onPreview,
+  onSave,
+  onSendCase,
+  onUploadFiles,
+}: TreatmentCasesEditorProps) {
+  const attachmentInputRef = useRef<HTMLInputElement>(null);
+  const activeCase = cases.find((c) => c.clientId === activeCaseId) ?? cases[0];
+  const activeLinkedOrganizations = orgs.filter((o) => o.active);
+  const filteredOrganizations = (() => {
+    const q = organizationSearch.trim().toLowerCase();
+    if (!q) return activeLinkedOrganizations;
+    return activeLinkedOrganizations.filter((o) => o.name.toLowerCase().includes(q));
+  })();
+  const recentOrganizations = recentOrganizationIds
+    .map((id) => activeLinkedOrganizations.find((o) => o.id === id))
+    .filter(Boolean) as LinkedOrganizationOption[];
+
+  const treatmentTypeTextColor = activeCase
+    ? (
+        {
+          consultation: '#ddd6fe',
+          filling: '#fed7aa',
+          endo: '#fecaca',
+          visit: '#bae6fd',
+          hygiene: '#d9f99d',
+        } as Record<TreatmentCaseDraft['treatmentType'], string>
+      )[activeCase.treatmentType]
+    : undefined;
+
+  if (!activeCase) return null;
+
+  return (
+    <div className="surface-card p-4 space-y-4">
+      <div className="flex flex-wrap items-center justify-between gap-3">
+        <div>
+          <h3 className="text-sm font-semibold text-text-primary">Treatment cases</h3>
+          <p className="text-xs text-text-muted mt-0.5">
+            Each case has its own teeth, notes, attachments, and destinations for send.
+          </p>
+        </div>
+        <div className="flex flex-wrap items-center gap-2">
+          <Button type="button" variant="secondary" disabled={!canEdit || disabled} onClick={onPreview}>
+            Preview
+          </Button>
+          <Button type="button" variant="primary" disabled={!canEdit || disabled} onClick={onAddCase}>
+            Add case
+          </Button>
+        </div>
+      </div>
+
+      <div className="flex flex-wrap gap-2">
+        {cases.map((c, idx) => {
+          const sentSummary = formatCaseSentSummary(c.sends, {
+            organizationIds: c.sendToOrganizationIds ?? [],
+            sentAt: c.sentAt ?? null,
+            orgs,
+          });
+          return (
+          <button
+            key={c.clientId}
+            type="button"
+            onClick={() => onActiveCaseChange(c.clientId)}
+            className={`
+              rounded-[var(--radius-md)] border px-3 py-1.5 text-sm transition-colors
+              focus:outline-none focus-visible:ring-2 focus-visible:ring-primary/45
+              ${
+                c.clientId === activeCaseId
+                  ? 'border-primary bg-primary-soft font-medium text-text-primary'
+                  : 'border-border/70 text-text-secondary hover:border-border hover:bg-background-card/50'
+              }
+            `}
+          >
+            Case {idx + 1}
+            {sentSummary ? ` · ${sentSummary}` : ''}
+          </button>
+          );
+        })}
+      </div>
+
+      <div className="space-y-4 border border-border/60 rounded-[var(--radius-md)] p-4 bg-background-secondary/30">
+        <label className="block text-xs font-medium text-text-secondary">
+          Comments
+          <textarea
+            value={activeCase.comment}
+            onChange={(e) => {
+              const v = e.target.value;
+              onCasesChange(
+                cases.map((c) => (c.clientId === activeCaseId ? { ...c, comment: v } : c)),
+              );
+            }}
+            placeholder="Write clinical notes for this case…"
+            rows={5}
+            disabled={disabled || Boolean(activeCase.sentAt)}
+            className="mt-1.5 w-full rounded-[var(--radius-md)] border border-border bg-background-secondary/90 text-text-primary text-sm px-3 py-2 placeholder:text-text-muted focus:outline-none focus:ring-2 focus:ring-primary/35 resize-y min-h-[120px]"
+          />
+        </label>
+
+        <div>
+          <Dropdown
+            label="Treatment type"
+            value={activeCase.treatmentType}
+            onChange={(e) => {
+              const nextType = e.target.value as TreatmentCaseDraft['treatmentType'];
+              onCasesChange(
+                cases.map((c) =>
+                  c.clientId === activeCaseId ? { ...c, treatmentType: nextType } : c,
+                ),
+              );
+            }}
+            disabled={disabled || Boolean(activeCase.sentAt)}
+            className="capitalize"
+            style={{ color: treatmentTypeTextColor }}
+          >
+            <option value="consultation" style={{ color: '#ddd6fe', backgroundColor: '#14253d' }} className="capitalize">consultation</option>
+            <option value="filling" style={{ color: '#fed7aa', backgroundColor: '#14253d' }} className="capitalize">filling</option>
+            <option value="endo" style={{ color: '#fecaca', backgroundColor: '#14253d' }} className="capitalize">endo</option>
+            <option value="visit" style={{ color: '#bae6fd', backgroundColor: '#14253d' }} className="capitalize">visit</option>
+            <option value="hygiene" style={{ color: '#d9f99d', backgroundColor: '#14253d' }} className="capitalize">hygiene</option>
+          </Dropdown>
+        </div>
+
+        <div>
+          <p className="text-xs font-medium text-text-secondary mb-2">Attachments</p>
+          <input
+            ref={attachmentInputRef}
+            id="treatment-case-attachments"
+            type="file"
+            multiple
+            disabled={disabled || uploadBusy || Boolean(activeCase.sentAt)}
+            onChange={(e) => {
+              onUploadFiles(e.target.files);
+              e.target.value = '';
+            }}
+            className="sr-only"
+            aria-label="Attach files for this treatment case"
+          />
+          <Button
+            type="button"
+            variant="primary"
+            disabled={disabled || uploadBusy || Boolean(activeCase.sentAt)}
+            isLoading={uploadBusy}
+            onClick={() => attachmentInputRef.current?.click()}
+            aria-controls="treatment-case-attachments"
+          >
+            Choose files
+          </Button>
+          {activeCase.attachmentMetas.length > 0 && (
+            <ul className="mt-2 space-y-1 text-xs text-text-muted">
+              {activeCase.attachmentMetas.map((f) => (
+                <li key={f.id} className="truncate">
+                  {f.fileName} ({(f.sizeBytes / 1024).toFixed(1)} KB)
+                </li>
+              ))}
+            </ul>
+          )}
+        </div>
+
+        <div>
+          <p className="text-xs font-medium text-text-secondary mb-2">
+            Send this case to linked organizations
+          </p>
+          <div className="space-y-2 mb-2">
+            <SearchBar
+              value={organizationSearch}
+              onChange={onOrganizationSearchChange}
+              placeholder="Search active organizations..."
+            />
+            {recentOrganizations.length > 0 && (
+              <div className="flex flex-wrap items-center gap-2">
+                <span className="text-xs text-text-muted">Recent:</span>
+                {recentOrganizations.map((o) => (
+                  <button
+                    key={o.id}
+                    type="button"
+                    disabled={disabled || Boolean(activeCase.sentAt)}
+                    onClick={() => onRecentOrganizationPick(o.id)}
+                    className="text-xs rounded-[var(--radius-sm)] border border-border/70 px-2 py-1 text-text-secondary hover:text-text-primary hover:border-border focus:outline-none focus-visible:ring-2 focus-visible:ring-primary/35 disabled:opacity-50"
+                  >
+                    {o.name}
+                  </button>
+                ))}
+              </div>
+            )}
+          </div>
+          <div className="flex flex-col gap-2">
+            {filteredOrganizations.map((o) => (
+              <Checkbox
+                key={o.id}
+                checked={activeCase.sendToOrganizationIds.includes(o.id)}
+                disabled={disabled || Boolean(activeCase.sentAt)}
+                onChange={(checked) => {
+                  onCasesChange(
+                    cases.map((c) => {
+                      if (c.clientId !== activeCaseId) return c;
+                      const next = new Set(c.sendToOrganizationIds);
+                      if (checked) next.add(o.id);
+                      else next.delete(o.id);
+                      return { ...c, sendToOrganizationIds: [...next] };
+                    }),
+                  );
+                }}
+                label={o.name}
+              />
+            ))}
+            {filteredOrganizations.length === 0 && (
+              <p className="text-xs text-text-muted">No active organization matches your search.</p>
+            )}
+          </div>
+        </div>
+
+        <div className="flex flex-wrap items-center gap-3 pt-1">
+          <Button
+            type="button"
+            variant="primary"
+            disabled={disabled || Boolean(activeCase.sentAt) || sendBusyId === activeCase.clientId}
+            isLoading={sendBusyId === activeCase.clientId}
+            onClick={() => onSendCase(activeCase)}
+          >
+            Send this case
+          </Button>
+          {activeCase.sentAt && (
+            <CaseSentLabel treatmentCase={activeCase} orgs={orgs} />
+          )}
+        </div>
+      </div>
+
+      {canEdit && (
+        <div className="flex flex-wrap gap-3 pt-2 border-t border-border/60">
+          <Button
+            type="button"
+            variant="primary"
+            disabled={disabled || saveBusy}
+            isLoading={saveBusy}
+            onClick={onSave}
+          >
+            Save treatment draft
+          </Button>
+          <p className="text-xs text-text-muted self-center">
+            {isDirty ? 'Unsaved changes' : 'Draft saved'}. Sending is per case and saves first automatically.
+          </p>
+        </div>
+      )}
+    </div>
+  );
+}
--- a/frontend/src/components/ui/treatment/TreatmentLatestAttachmentPreview.tsx
+++ b/frontend/src/components/ui/treatment/TreatmentLatestAttachmentPreview.tsx
@@ -0,0 +1,104 @@
+'use client';
+
+import { useEffect, useState } from 'react';
+import { FileText } from 'lucide-react';
+import { treatmentsApi } from '@/lib/api/treatments';
+import type { TreatmentAttachmentMeta } from '@/types/treatment';
+
+interface TreatmentLatestAttachmentPreviewProps {
+  attachment?: TreatmentAttachmentMeta | null;
+  className?: string;
+}
+
+function isImageMime(mimeType: string): boolean {
+  return mimeType.startsWith('image/');
+}
+
+function isPdfMime(mimeType: string): boolean {
+  return mimeType === 'application/pdf';
+}
+
+export function TreatmentLatestAttachmentPreview({
+  attachment,
+  className = '',
+}: TreatmentLatestAttachmentPreviewProps) {
+  const [previewUrl, setPreviewUrl] = useState<string | null>(null);
+  const [loadFailed, setLoadFailed] = useState(false);
+  const [loading, setLoading] = useState(false);
+
+  const canRenderPreview = attachment
+    ? isImageMime(attachment.mimeType) || isPdfMime(attachment.mimeType)
+    : false;
+
+  useEffect(() => {
+    if (!attachment || !canRenderPreview) {
+      setPreviewUrl(null);
+      setLoadFailed(false);
+      setLoading(false);
+      return;
+    }
+
+    let cancelled = false;
+    let objectUrl: string | null = null;
+
+    setLoading(true);
+    setLoadFailed(false);
+    setPreviewUrl(null);
+
+    void treatmentsApi
+      .getAttachmentFileBlob(attachment.id)
+      .then((blob) => {
+        if (cancelled) return;
+        objectUrl = URL.createObjectURL(blob);
+        setPreviewUrl(objectUrl);
+      })
+      .catch(() => {
+        if (!cancelled) setLoadFailed(true);
+      })
+      .finally(() => {
+        if (!cancelled) setLoading(false);
+      });
+
+    return () => {
+      cancelled = true;
+      if (objectUrl) URL.revokeObjectURL(objectUrl);
+    };
+  }, [attachment, canRenderPreview]);
+
+  return (
+    <div
+      className={`aspect-square w-[6rem] shrink-0 overflow-hidden rounded-[var(--radius-md)] border border-border/70 bg-background-secondary/50 ${className}`}
+      title={attachment?.fileName}
+    >
+      {!attachment ? (
+        <div className="flex h-full w-full items-center justify-center text-[10px] text-text-muted">
+          None
+        </div>
+      ) : loading ? (
+        <div className="flex h-full w-full items-center justify-center text-[10px] text-text-muted">
+          …
+        </div>
+      ) : loadFailed || !canRenderPreview || !previewUrl ? (
+        <div className="flex h-full w-full flex-col items-center justify-center gap-1 p-1.5 text-center">
+          <FileText className="h-4 w-4 shrink-0 icon-flat text-text-muted" aria-hidden />
+          <span className="line-clamp-2 text-[9px] leading-tight text-text-secondary">
+            {attachment.fileName}
+          </span>
+        </div>
+      ) : isImageMime(attachment.mimeType) ? (
+        // eslint-disable-next-line @next/next/no-img-element
+        <img
+          src={previewUrl}
+          alt={attachment.fileName}
+          className="h-full w-full object-fill"
+        />
+      ) : (
+        <iframe
+          src={previewUrl}
+          title={attachment.fileName}
+          className="h-full w-full border-0"
+        />
+      )}
+    </div>
+  );
+}
--- a/frontend/src/components/ui/treatment/TreatmentPreviewCard.tsx
+++ b/frontend/src/components/ui/treatment/TreatmentPreviewCard.tsx
@@ -0,0 +1,56 @@
+'use client';
+
+import { Button } from '@/components/ui/shared/Button';
+import type { PastTreatment } from '@/types/treatment';
+
+interface TreatmentPreviewCardProps {
+  draft: PastTreatment | null;
+  disabled?: boolean;
+  onPreview: () => void;
+}
+
+export function TreatmentPreviewCard({ draft, disabled, onPreview }: TreatmentPreviewCardProps) {
+  return (
+    <div className="surface-card p-4 space-y-3">
+      <div className="flex items-center justify-between gap-2">
+        <h3 className="text-sm font-semibold text-text-primary">Treatment preview</h3>
+        <Button type="button" variant="primary" disabled={disabled || !draft} onClick={onPreview}>
+          Preview current draft
+        </Button>
+      </div>
+      {!draft ? (
+        <p className="text-sm text-text-muted">Select an appointment to preview its draft.</p>
+      ) : (
+        <div className="border border-border/70 rounded-[var(--radius-md)] p-3 bg-background-secondary/40 space-y-2">
+          <div className="flex items-start justify-between gap-2">
+            <p className="text-sm font-medium text-text-primary">{draft.title}</p>
+            <span className="text-xs text-text-muted tabular-nums shrink-0 capitalize">{draft.status}</span>
+          </div>
+          <p className="text-xs text-text-secondary">
+            {draft.cases.length} case{draft.cases.length === 1 ? '' : 's'} ·{' '}
+            {draft.cases.reduce((n, c) => n + (c.attachmentMetas?.length ?? 0), 0)} attachment
+            {draft.cases.reduce((n, c) => n + (c.attachmentMetas?.length ?? 0), 0) === 1 ? '' : 's'}
+          </p>
+          <div className="space-y-2">
+            {draft.cases.slice(0, 2).map((c, idx) => (
+              <div
+                key={c.id}
+                className="rounded-[var(--radius-sm)] border border-border/60 px-2.5 py-2 text-xs text-text-secondary"
+              >
+                <span className="text-text-primary font-medium capitalize">
+                  Case {idx + 1}: {c.treatmentType}
+                </span>
+                {c.teeth.length > 0 && (
+                  <span className="ml-1 tabular-nums">· Teeth {[...c.teeth].sort().join(', ')}</span>
+                )}
+              </div>
+            ))}
+            {draft.cases.length > 2 && (
+              <p className="text-xs text-text-muted">+ {draft.cases.length - 2} more case(s)</p>
+            )}
+          </div>
+        </div>
+      )}
+    </div>
+  );
+}
--- a/frontend/src/components/ui/treatment/TreatmentPreviewDialog.tsx
+++ b/frontend/src/components/ui/treatment/TreatmentPreviewDialog.tsx
@@ -0,0 +1,235 @@
+'use client';
+
+import { useRef, useState } from 'react';
+import { Loader2, Paperclip, Send } from 'lucide-react';
+import { DialogCloseButton } from '@/components/ui/shared/DialogCloseButton';
+import { Button } from '@/components/ui/shared/Button';
+import { Checkbox } from '@/components/ui/shared/Checkbox';
+import type { LinkedOrganizationOption, PastTreatment, PastTreatmentCase } from '@/types/treatment';
+import { CaseSentLabel } from '@/components/ui/treatment/CaseSentLabel';
+import { TreatmentLatestAttachmentPreview } from '@/components/ui/treatment/TreatmentLatestAttachmentPreview';
+
+export type TreatmentPreviewMode = 'readonly' | 'editable';
+
+interface TreatmentPreviewDialogProps {
+  open: boolean;
+  onClose: () => void;
+  treatment: PastTreatment | null;
+  mode: TreatmentPreviewMode;
+  orgs?: LinkedOrganizationOption[];
+  sendBusyCaseId?: string | null;
+  uploadBusyCaseId?: string | null;
+  onAttach?: (caseKey: string, files: FileList) => void | Promise<void>;
+  onSend?: (caseKey: string, organizationIds: string[]) => void | Promise<void>;
+  getCaseOrgIds?: (caseKey: string) => string[];
+  onToggleCaseOrg?: (caseKey: string, organizationId: string, checked: boolean) => void;
+}
+
+function caseKey(c: PastTreatmentCase): string {
+  return c.clientId ?? c.id;
+}
+
+const caseActionIconClass =
+  'inline-flex items-center justify-center rounded-[var(--radius-sm)] p-1.5 text-text-secondary transition-colors hover:bg-background-card/80 hover:text-text-primary disabled:cursor-not-allowed disabled:opacity-40';
+
+export function TreatmentPreviewDialog({
+  open,
+  onClose,
+  treatment,
+  mode,
+  orgs = [],
+  sendBusyCaseId,
+  uploadBusyCaseId,
+  onAttach,
+  onSend,
+  getCaseOrgIds,
+  onToggleCaseOrg,
+}: TreatmentPreviewDialogProps) {
+  const [expandedSendCaseId, setExpandedSendCaseId] = useState<string | null>(null);
+  const fileInputsRef = useRef<Record<string, HTMLInputElement | null>>({});
+
+  if (!open || !treatment) return null;
+
+  const editable = mode === 'editable';
+  const activeOrgs = orgs.filter((o) => o.active);
+
+  return (
+    <div className="fixed inset-0 z-50 flex items-center justify-center p-4 bg-black/50">
+      <div
+        className="w-full max-w-[min(56rem,calc(100vw-17rem))] max-h-[90vh] overflow-y-auto rounded-[var(--radius-md)] border border-border bg-background-secondary p-6 shadow-xl space-y-4"
+        role="dialog"
+        aria-modal="true"
+        aria-labelledby="treatment-preview-title"
+      >
+        <div className="flex items-start justify-between gap-3">
+          <div className="min-w-0">
+            <h2 id="treatment-preview-title" className="text-lg font-semibold text-text-primary pr-2">
+              Treatment preview
+            </h2>
+            <p className="text-xs text-text-muted mt-0.5">
+              Review cases, attachments, and send destinations.
+            </p>
+          </div>
+          <DialogCloseButton onClick={onClose} />
+        </div>
+
+        <div className="border border-border/70 rounded-[var(--radius-md)] p-4 bg-background-secondary/40 space-y-3">
+          <div className="flex items-start justify-between gap-2">
+            <p className="text-sm font-medium text-text-primary">{treatment.title}</p>
+            <span className="text-xs text-text-muted tabular-nums shrink-0">
+              {new Date(treatment.treatmentAt).toLocaleDateString()}
+            </span>
+          </div>
+          <p className="text-xs text-text-secondary capitalize">Status: {treatment.status}</p>
+
+          {treatment.cases.length === 0 ? (
+            <p className="text-sm text-text-muted">No cases in this treatment.</p>
+          ) : (
+            <div className="space-y-2">
+              {treatment.cases.map((c, idx) => {
+                const key = caseKey(c);
+                const attachments = c.attachmentMetas ?? [];
+                const latestAttachment =
+                  attachments.length > 0 ? attachments[attachments.length - 1] : null;
+                const sent = Boolean(c.sentAt);
+                const actionsEnabled = editable && !sent;
+                const selectedOrgIds = getCaseOrgIds?.(key) ?? c.sendToOrganizationIds ?? [];
+                const sendExpanded = expandedSendCaseId === key;
+                const comment = c.notes?.trim() ?? '';
+                const attachBusy = uploadBusyCaseId === key;
+                const sendBusy = sendBusyCaseId === key;
+
+                return (
+                  <div
+                    key={key}
+                    className="rounded-[var(--radius-md)] border border-border/60 px-3 py-2 bg-background-secondary/30"
+                  >
+                    <div className="grid grid-cols-[minmax(0,1fr)_auto] gap-x-4 gap-y-1">
+                      <div className="min-w-0 space-y-0.5">
+                        <div className="flex items-center gap-2">
+                          <p className="text-xs font-medium text-text-primary">Case {idx + 1}</p>
+                          {actionsEnabled && (
+                            <div className="flex items-center gap-0.5">
+                              <input
+                                ref={(el) => {
+                                  fileInputsRef.current[key] = el;
+                                }}
+                                type="file"
+                                multiple
+                                className="sr-only"
+                                aria-hidden
+                                onChange={(e) => {
+                                  if (e.target.files?.length) {
+                                    void onAttach?.(key, e.target.files);
+                                  }
+                                  e.target.value = '';
+                                }}
+                              />
+                              <button
+                                type="button"
+                                className={caseActionIconClass}
+                                disabled={attachBusy}
+                                aria-label="Attach files"
+                                title="Attach files"
+                                onClick={() => fileInputsRef.current[key]?.click()}
+                              >
+                                {attachBusy ? (
+                                  <Loader2 className="h-3.5 w-3.5 animate-spin" aria-hidden />
+                                ) : (
+                                  <Paperclip className="h-3.5 w-3.5" aria-hidden />
+                                )}
+                              </button>
+                              <button
+                                type="button"
+                                className={`${caseActionIconClass} ${
+                                  sendExpanded ? 'bg-primary-soft text-primary' : ''
+                                }`}
+                                disabled={sendBusy}
+                                aria-label="Send this case"
+                                title="Send this case"
+                                aria-expanded={sendExpanded}
+                                onClick={() =>
+                                  setExpandedSendCaseId((prev) => (prev === key ? null : key))
+                                }
+                              >
+                                {sendBusy ? (
+                                  <Loader2 className="h-3.5 w-3.5 animate-spin" aria-hidden />
+                                ) : (
+                                  <Send className="h-3.5 w-3.5" aria-hidden />
+                                )}
+                              </button>
+                            </div>
+                          )}
+                        </div>
+                        <p className="text-[11px] text-text-secondary capitalize">
+                          Type: {c.treatmentType}
+                        </p>
+                        <p className="text-[11px] text-text-secondary">
+                          Teeth:{' '}
+                          {c.teeth.length ? [...c.teeth].sort().join(', ') : 'None selected'}
+                        </p>
+                        {comment ? (
+                          <p className="text-[11px] text-text-muted line-clamp-2" title={comment}>
+                            Comments: {comment}
+                          </p>
+                        ) : (
+                          <p className="text-[11px] text-text-muted">Comments: —</p>
+                        )}
+                      </div>
+
+                      <div className="flex min-w-[6rem] flex-col items-end gap-1">
+                        {sent && (
+                          <CaseSentLabel
+                            treatmentCase={c}
+                            orgs={orgs}
+                            className="text-[10px] text-text-muted text-right"
+                          />
+                        )}
+                        <p className="text-[10px] uppercase tracking-wide text-text-muted">
+                          Attachments
+                        </p>
+                        <TreatmentLatestAttachmentPreview attachment={latestAttachment} />
+                      </div>
+                    </div>
+
+                    {sendExpanded && editable && !sent && (
+                      <div className="mt-2 space-y-2 border-t border-border/40 pt-2">
+                        <p className="text-xs font-medium text-text-secondary">
+                          Send to linked organizations
+                        </p>
+                        {activeOrgs.length === 0 ? (
+                          <p className="text-xs text-text-muted">No active linked organizations.</p>
+                        ) : (
+                          <div className="flex flex-col gap-1.5">
+                            {activeOrgs.map((o) => (
+                              <Checkbox
+                                key={o.id}
+                                checked={selectedOrgIds.includes(o.id)}
+                                onChange={(checked) => onToggleCaseOrg?.(key, o.id, checked)}
+                                label={o.name}
+                              />
+                            ))}
+                          </div>
+                        )}
+                        <Button
+                          type="button"
+                          variant="primary"
+                          size="sm"
+                          disabled={!selectedOrgIds.length || sendBusy}
+                          isLoading={sendBusy}
+                          onClick={() => void onSend?.(key, selectedOrgIds)}
+                        >
+                          Confirm send
+                        </Button>
+                      </div>
+                    )}
+                  </div>
+                );
+              })}
+            </div>
+          )}
+        </div>
+      </div>
+    </div>
+  );
+}
--- a/frontend/src/components/ui/treatment/TreatmentWorkspace.tsx
+++ b/frontend/src/components/ui/treatment/TreatmentWorkspace.tsx
--- a/frontend/src/lib/api/patients.ts
+++ b/frontend/src/lib/api/patients.ts
@@ -1,10 +1,8 @@
 import { apiClient } from './client';
 import {
  CreatePatientInput,
-  CreateTreatmentHistoryInput,
  Patient,
  PatientsListResponse,
-  TreatmentHistoryItem,
 } from '@/types/patient';

 export const patientsApi = {
@@ -22,22 +20,4 @@ export const patientsApi = {
    const response = await apiClient.get(`/patients/${id}`);
    return response.data;
  },
-
-  listTreatments: async (
-    patientId: string,
-    limit = 20,
-  ): Promise<{ success: boolean; data: TreatmentHistoryItem[] }> => {
-    const response = await apiClient.get(`/patients/${patientId}/treatments`, {
-      params: { limit },
-    });
-    return response.data;
-  },
-
-  addTreatment: async (
-    patientId: string,
-    data: CreateTreatmentHistoryInput,
-  ): Promise<{ success: boolean; data: TreatmentHistoryItem }> => {
-    const response = await apiClient.post(`/patients/${patientId}/treatments`, data);
-    return response.data;
-  },
 };
--- a/frontend/src/lib/api/treatments.ts
+++ b/frontend/src/lib/api/treatments.ts
@@ -0,0 +1,86 @@
+import { apiClient } from './client';
+import type {
+  LinkedOrganizationOption,
+  PastTreatment,
+  SaveTreatmentPayload,
+  SendTreatmentCasePayload,
+  TreatmentAttachmentMeta,
+  TreatmentCaseSendInfo,
+} from '@/types/treatment';
+
+export const treatmentsApi = {
+  listLinkedOrganizations: async (): Promise<{ success: boolean; data: LinkedOrganizationOption[] }> => {
+    const response = await apiClient.get('/treatments/linked-organizations');
+    return response.data;
+  },
+
+  listPatientHistory: async (
+    patientId: string,
+    limit = 20,
+  ): Promise<{ success: boolean; data: PastTreatment[] }> => {
+    const response = await apiClient.get(`/treatments/patients/${patientId}/history`, {
+      params: { limit },
+    });
+    return response.data;
+  },
+
+  getDraft: async (
+    appointmentId: string,
+  ): Promise<{ success: boolean; data: PastTreatment | null }> => {
+    const response = await apiClient.get(`/treatments/appointments/${appointmentId}/draft`);
+    return response.data;
+  },
+
+  saveDraft: async (
+    appointmentId: string,
+    payload: Pick<SaveTreatmentPayload, 'cases'>,
+  ): Promise<{ success: boolean; data: PastTreatment }> => {
+    const response = await apiClient.put(`/treatments/appointments/${appointmentId}/draft`, payload);
+    return response.data;
+  },
+
+  uploadCaseAttachments: async (
+    appointmentId: string,
+    caseClientId: string,
+    files: File[],
+  ): Promise<{ success: boolean; data: TreatmentAttachmentMeta[] }> => {
+    const form = new FormData();
+    for (const file of files) {
+      form.append('files', file);
+    }
+    const response = await apiClient.post(
+      `/treatments/appointments/${appointmentId}/cases/${encodeURIComponent(caseClientId)}/attachments`,
+      form,
+      { headers: { 'Content-Type': 'multipart/form-data' }, timeout: 120_000 },
+    );
+    return response.data;
+  },
+
+  sendCase: async (
+    caseId: string,
+    payload: SendTreatmentCasePayload,
+  ): Promise<{ success: boolean; data: PastTreatmentCaseResponse }> => {
+    const response = await apiClient.post(`/treatments/cases/${caseId}/send`, payload);
+    return response.data;
+  },
+
+  getAttachmentFileBlob: async (attachmentId: string): Promise<Blob> => {
+    const response = await apiClient.get(`/treatments/attachments/${attachmentId}/file`, {
+      responseType: 'blob',
+      timeout: 120_000,
+    });
+    return response.data;
+  },
+};
+
+export interface PastTreatmentCaseResponse {
+  id: string;
+  clientId: string;
+  treatmentType: string;
+  teeth: string[];
+  notes: string | null;
+  sentAt: string | null;
+  sendToOrganizationIds: string[];
+  sends: TreatmentCaseSendInfo[];
+  attachmentMetas: TreatmentAttachmentMeta[];
+}
--- a/frontend/src/lib/mocks/treatmentMockApi.ts
+++ b/frontend/src/lib/mocks/treatmentMockApi.ts
@@ -1,200 +0,0 @@
-import {
-  addCalendarDays,
-  isSameLocalCalendarDay,
-  startOfLocalDay,
-} from '@/components/appointments/appointmentTime';
-import type {
-  FdiToothId,
-  LinkedOrganizationOption,
-  PastTreatment,
-  SaveTreatmentPayload,
-  SendTreatmentRecordPayload,
-  TreatmentAppointment,
-} from '@/types/treatment';
-
-const MOCK_DELAY_MS = 280;
-
-function sleep(ms = MOCK_DELAY_MS) {
-  return new Promise<void>((resolve) => setTimeout(resolve, ms));
-}
-
-function pad2(n: number) {
-  return String(n).padStart(2, '0');
-}
-
-/** Builds deterministic ids so React keys stay stable across hot reloads */
-function mockApptId(dayKey: string, slotIndex: number | string) {
-  return `mock-appt-${dayKey}-${slotIndex}`;
-}
-
-function buildSlotsForDay(day: Date, userId: string): TreatmentAppointment[] {
-  const dayStart = startOfLocalDay(day);
-  const y = dayStart.getFullYear();
-  const m = dayStart.getMonth();
-  const d = dayStart.getDate();
-  const dayKey = `${y}-${pad2(m + 1)}-${pad2(d)}`;
-
-  const base: Omit<TreatmentAppointment, 'id' | 'startAt' | 'endAt'>[] = [
-    {
-      patientId: 'pat-alice',
-      patientFirstName: 'Alice',
-      patientLastName: 'Moradi',
-      providerUserId: userId,
-      purpose: 'consultation',
-    },
-    {
-      patientId: 'pat-babak',
-      patientFirstName: 'Babak',
-      patientLastName: 'Karimi',
-      providerUserId: userId,
-      purpose: 'filling',
-    },
-    {
-      patientId: 'pat-sara',
-      patientFirstName: 'Sara',
-      patientLastName: 'Hosseini',
-      providerUserId: userId,
-      purpose: 'endo',
-    },
-  ];
-
-  const slots: TreatmentAppointment[] = [];
-  const times = [
-    [9, 0, 9, 45],
-    [11, 15, 12, 0],
-    [14, 30, 15, 30],
-  ];
-
-  times.forEach(([h1, m1, h2, m2], i) => {
-    const baseSlot = base[i % base.length];
-    const startAt = new Date(y, m, d, h1, m1, 0, 0).toISOString();
-    const endAt = new Date(y, m, d, h2, m2, 0, 0).toISOString();
-    slots.push({
-      id: mockApptId(dayKey, i),
-      ...baseSlot,
-      startAt,
-      endAt,
-    });
-  });
-
-  const today = new Date();
-  if (isSameLocalCalendarDay(day, today)) {
-    const now = today.getTime();
-    const start = new Date(now - 12 * 60 * 1000);
-    const end = new Date(now + 48 * 60 * 1000);
-    slots.unshift({
-      id: mockApptId(dayKey, 'now'),
-      patientId: 'pat-hesam',
-      patientFirstName: 'Hesam',
-      patientLastName: 'Aghaie',
-      providerUserId: userId,
-      startAt: start.toISOString(),
-      endAt: end.toISOString(),
-      purpose: 'visit',
-    });
-  }
-
-  return slots.sort((a, b) => new Date(a.startAt).getTime() - new Date(b.startAt).getTime());
-}
-
-const MOCK_HISTORY: Record<string, PastTreatment[]> = {
-  'pat-hesam': [
-    {
-      id: 'pt-h-1',
-      patientId: 'pat-hesam',
-      title: 'Root canal 45',
-      treatmentAt: new Date(2026, 8, 12).toISOString(),
-      status: 'completed',
-      records: [
-        {
-          id: 'ptr-1',
-          treatmentType: 'endo',
-          teeth: ['45'] as FdiToothId[],
-          notes: 'Instrumented and temporized.',
-        },
-      ],
-      documents: [
-        {
-          id: 'doc-1',
-          fileName: 'periapical-45.png',
-          mimeType: 'image/png',
-          sizeBytes: 842_120,
-        },
-        {
-          id: 'doc-2',
-          fileName: 'consent-signed.pdf',
-          mimeType: 'application/pdf',
-          sizeBytes: 312_000,
-        },
-      ],
-    },
-    {
-      id: 'pt-h-2',
-      patientId: 'pat-hesam',
-      title: 'Filling 14, 15',
-      treatmentAt: new Date(2025, 9, 10).toISOString(),
-      status: 'completed',
-      records: [
-        {
-          id: 'ptr-2',
-          treatmentType: 'filling',
-          teeth: ['14', '15'] as FdiToothId[],
-          notes: 'Composite restoration.',
-        },
-      ],
-      documents: [
-        {
-          id: 'doc-3',
-          fileName: 'notes.txt',
-          mimeType: 'text/plain',
-          sizeBytes: 420,
-        },
-      ],
-    },
-  ],
-  'pat-alice': [
-    {
-      id: 'pt-a-1',
-      patientId: 'pat-alice',
-      title: 'Hygiene visit',
-      treatmentAt: addCalendarDays(new Date(), -21).toISOString(),
-      status: 'completed',
-      records: [{ id: 'ptr-a', treatmentType: 'hygiene', teeth: [], notes: 'Scale & polish.' }],
-      documents: [],
-    },
-  ],
-};
-
-const MOCK_ORGS: LinkedOrganizationOption[] = [
-  { id: 'org-lab-north', name: 'North Dental Lab', active: true },
-  { id: 'org-lab-smile', name: 'Smile Ceramics', active: true },
-  { id: 'org-lab-old', name: 'Legacy Lab (inactive)', active: false },
-];
-
-export async function fetchMyAppointmentsForDay(
-  userId: string,
-  day: Date,
-): Promise<TreatmentAppointment[]> {
-  await sleep();
-  return buildSlotsForDay(day, userId);
-}
-
-export async function fetchPastTreatments(patientId: string): Promise<PastTreatment[]> {
-  await sleep();
-  return MOCK_HISTORY[patientId] ?? [];
-}
-
-export async function fetchLinkedOrganizations(): Promise<LinkedOrganizationOption[]> {
-  await sleep(180);
-  return MOCK_ORGS;
-}
-
-export async function saveTreatmentDraft(_payload: SaveTreatmentPayload): Promise<{ ok: true }> {
-  await sleep();
-  return { ok: true };
-}
-
-export async function sendTreatmentRecord(_payload: SendTreatmentRecordPayload): Promise<{ ok: true }> {
-  await sleep();
-  return { ok: true };
-}
--- a/frontend/src/types/patient.ts
+++ b/frontend/src/types/patient.ts
@@ -12,19 +12,6 @@ export interface Patient {
  updatedAt: string;
 }

-export interface TreatmentHistoryItem {
-  id: string;
-  patientId: string;
-  title: string;
-  status: string;
-  treatmentAt: string;
-  tooth?: string | null;
-  notes?: string | null;
-  totalCost?: number | null;
-  createdAt: string;
-  updatedAt: string;
-}
-
 export interface CreatePatientInput {
  firstName: string;
  lastName: string;
@@ -34,15 +21,6 @@ export interface CreatePatientInput {
  notes?: string;
 }

-export interface CreateTreatmentHistoryInput {
-  title: string;
-  status: string;
-  treatmentAt: string;
-  tooth?: string;
-  notes?: string;
-  totalCost?: number;
-}
-
 export interface PatientsListResponse {
  success: boolean;
  data: {
--- a/frontend/src/types/treatment.ts
+++ b/frontend/src/types/treatment.ts
@@ -61,20 +61,32 @@ export const TREATMENT_TYPES = [

 export type TreatmentType = (typeof TREATMENT_TYPES)[number];

-export interface PastTreatmentRecord {
+export interface TreatmentCaseSendInfo {
+  organizationId: string;
+  organizationName: string;
+  sentAt: string;
+}
+
+export interface PastTreatmentCase {
  id: string;
+  clientId: string;
  treatmentType: TreatmentType;
  teeth: FdiToothId[];
  notes?: string | null;
+  attachmentMetas?: TreatmentAttachmentMeta[];
+  sendToOrganizationIds?: string[];
+  sends?: TreatmentCaseSendInfo[];
+  sentAt?: string | null;
 }

 export interface PastTreatment {
  id: string;
  patientId: string;
+  appointmentId?: string | null;
  title: string;
  treatmentAt: string;
  status: string;
-  records: PastTreatmentRecord[];
+  cases: PastTreatmentCase[];
  documents: TreatmentAttachmentMeta[];
 }

@@ -84,29 +96,33 @@ export interface LinkedOrganizationOption {
  active: boolean;
 }

-export interface TreatmentRecordDraft {
+export interface TreatmentCaseDraft {
  clientId: string;
+  id?: string;
  treatmentType: TreatmentType;
  teeth: FdiToothId[];
  comment: string;
  attachmentMetas: TreatmentAttachmentMeta[];
-  /** Organizations selected for sending this record (mock only until API exists) */
  sendToOrganizationIds: string[];
+  sends?: TreatmentCaseSendInfo[];
  sentAt?: string | null;
 }

-/** Payload for persisting a draft (mock API); omits ephemeral client-only fields */
-export type SavedTreatmentRecordPayload = Omit<TreatmentRecordDraft, 'clientId' | 'sentAt'>;
+export type SavedTreatmentCasePayload = {
+  clientId: string;
+  id?: string;
+  treatmentType: TreatmentType;
+  teeth: FdiToothId[];
+  comment: string;
+  attachmentIds: string[];
+};

 export interface SaveTreatmentPayload {
  appointmentId: string;
  patientId: string;
-  records: SavedTreatmentRecordPayload[];
+  cases: SavedTreatmentCasePayload[];
 }

-export interface SendTreatmentRecordPayload {
-  appointmentId: string;
-  patientId: string;
-  recordClientId: string;
+export interface SendTreatmentCasePayload {
  organizationIds: string[];
 }