diff --git a/scripts/run-api-redis-tests.sh b/scripts/run-api-redis-tests.sh
index 93832b7..7b42936 100755
--- a/scripts/run-api-redis-tests.sh
+++ b/scripts/run-api-redis-tests.sh
@@ -109,6 +109,12 @@ echo ""
 echo "[1/${TOTAL_STEPS}] Listing thresholds"
 resp="$(request GET "${BASE_URL}/api/v1/alert-thresholds")"
 assert_status "200" "${resp}"
+threshold_count="$(jq -r '.data | length' "${resp}")"
+if [[ "${threshold_count}" -lt 12 ]]; then
+  echo "Expected at least 12 alert thresholds, found ${threshold_count}."
+  exit 1
+fi
+echo "OK: ${threshold_count} threshold(s) configured"
 threshold_id="$(jq -r '.data[] | select(.observationCode=="HEART_RATE") | .id' "${resp}" | head -n 1)"
 if [[ -z "${threshold_id}" || "${threshold_id}" == "null" ]]; then
   echo "Could not find HEART_RATE threshold id."
diff --git a/scripts/run-phase10-verification.sh b/scripts/run-phase10-verification.sh
new file mode 100755
index 0000000..13a985b
--- /dev/null
+++ b/scripts/run-phase10-verification.sh
@@ -0,0 +1,294 @@
+#!/usr/bin/env bash
+
+set -euo pipefail
+
+SCRIPT_DIR="$(cd "$(dirname "${BASH_SOURCE[0]}")" && pwd)"
+ROOT_DIR="$(cd "${SCRIPT_DIR}/.." && pwd)"
+COMPOSE_FILE="${COMPOSE_FILE:-${ROOT_DIR}/docker-compose.yml}"
+
+BASE_URL="${BASE_URL:-http://localhost:5270}"
+ES_URL="${ES_URL:-http://localhost:9200}"
+REDIS_PORT="${REDIS_PORT:-6382}"
+TEST_PROJECT="${TEST_PROJECT:-${ROOT_DIR}/VigilCareClinicalAPI.Tests/VigilCareClinicalAPI.Tests.csproj}"
+TEST_FILTER="${TEST_FILTER:-FullyQualifiedName~ClinicalDemographicsAndObservationTests}"
+ES_CONSUMER_GROUP="${ES_CONSUMER_GROUP:-es-indexer}"
+INDEX_WAIT_SECS="${INDEX_WAIT_SECS:-60}"
+PIPELINE_WAIT_SECS="${PIPELINE_WAIT_SECS:-45}"
+
+EXPECTED_THRESHOLD_CODES=(
+  HEART_RATE
+  TEMP_C
+  POTASSIUM_MEQ_L
+  SPO2
+  RESP_RATE
+  WBC_K_UL
+  SYSTOLIC_BP
+  DIASTOLIC_BP
+  LACTATE_MMOL_L
+  AVPU
+  SUPPLEMENTAL_O2
+  GLUCOSE_MG_DL
+)
+
+NEW_OBSERVATION_CODES=(
+  SYSTOLIC_BP
+  DIASTOLIC_BP
+  LACTATE_MMOL_L
+  AVPU
+  SUPPLEMENTAL_O2
+)
+
+TMP_FILES=()
+cleanup() {
+  local f
+  for f in "${TMP_FILES[@]}"; do
+    rm -f "${f}" "${f}.status" 2>/dev/null || true
+  done
+}
+trap cleanup EXIT
+
+need() {
+  command -v "$1" >/dev/null 2>&1 || {
+    echo "Missing dependency: $1"
+    exit 1
+  }
+}
+
+need curl
+need jq
+need dotnet
+
+if ! command -v docker >/dev/null 2>&1 || [[ ! -f "${COMPOSE_FILE}" ]]; then
+  echo "Missing dependency: docker compose (${COMPOSE_FILE})"
+  exit 1
+fi
+
+compose() {
+  docker compose -f "${COMPOSE_FILE}" "$@"
+}
+
+redis_cmd() {
+  if command -v redis-cli >/dev/null 2>&1; then
+    redis-cli -p "${REDIS_PORT}" "$@"
+  else
+    compose exec -T redis redis-cli "$@"
+  fi
+}
+
+request() {
+  local method="$1"
+  local url="$2"
+  local body="${3:-}"
+  local tmp
+  tmp="$(mktemp)"
+  TMP_FILES+=("${tmp}")
+  local status
+
+  if [[ -n "${body}" ]]; then
+    status="$(curl -sS -o "${tmp}" -w "%{http_code}" -X "${method}" "${url}" \
+      -H "Content-Type: application/json" -d "${body}")"
+  else
+    status="$(curl -sS -o "${tmp}" -w "%{http_code}" -X "${method}" "${url}")"
+  fi
+
+  echo "${status}" > "${tmp}.status"
+  echo "${tmp}"
+}
+
+assert_status() {
+  local expected="$1"
+  local body_file="$2"
+  local status
+  status="$(<"${body_file}.status")"
+  if [[ "${status}" != "${expected}" ]]; then
+    echo "Expected HTTP ${expected}, got ${status}"
+    cat "${body_file}"
+    echo
+    exit 1
+  fi
+}
+
+indexer_lag() {
+  compose exec -T kafka /opt/kafka/bin/kafka-consumer-groups.sh \
+    --bootstrap-server localhost:9092 \
+    --describe \
+    --group "${ES_CONSUMER_GROUP}" 2>/dev/null | \
+    awk 'NR > 1 && $1 != "" { sum += $6 } END { print sum + 0 }'
+}
+
+wait_for_indexer_lag_zero() {
+  local elapsed=0
+  local lag="unknown"
+  while (( elapsed < INDEX_WAIT_SECS )); do
+    lag="$(indexer_lag)"
+    if [[ "${lag}" == "0" ]]; then
+      return 0
+    fi
+    sleep 2
+    elapsed=$((elapsed + 2))
+  done
+  echo "es-indexer lag did not reach zero within ${INDEX_WAIT_SECS}s (lag=${lag})"
+  exit 1
+}
+
+es_observation_hits() {
+  local code="$1"
+  local encounter_id="$2"
+  local payload
+  payload="$(jq -nc \
+    --arg code "${code}" \
+    --arg enc "${encounter_id}" \
+    '{query:{bool:{must:[{term:{observationCode:$code}},{term:{encounterId:$enc}}]}},size:0,track_total_hits:true}')"
+  local body
+  body="$(curl -sS "${ES_URL}/observations/_search" \
+    -H "Content-Type: application/json" \
+    -d "${payload}")"
+  jq -r '.hits.total.value // .hits.total // 0' <<< "${body}"
+}
+
+echo "Phase 10 verification starting..."
+echo "Repo root: ${ROOT_DIR}"
+echo "API: ${BASE_URL}"
+
+echo "[1/9] Preflight API, Elasticsearch, and Redis"
+api_status="$(curl -sS -o /dev/null -w "%{http_code}" "${BASE_URL}/api/v1/alert-thresholds" || true)"
+es_status="$(curl -sS -o /dev/null -w "%{http_code}" "${ES_URL}/_cluster/health" || true)"
+[[ "${api_status}" == "200" ]] || { echo "API not ready (${api_status})"; exit 1; }
+[[ "${es_status}" == "200" ]] || { echo "Elasticsearch not ready (${es_status})"; exit 1; }
+redis_cmd PING >/dev/null || { echo "Redis not reachable on port ${REDIS_PORT}"; exit 1; }
+
+echo "[2/9] Verify Redis threshold cache has 12 keys"
+mapfile -t redis_keys < <(redis_cmd KEYS 'threshold:*')
+threshold_count="${#redis_keys[@]}"
+[[ "${threshold_count}" -eq 12 ]] || {
+  echo "Expected 12 Redis threshold keys, found ${threshold_count}"
+  printf '  %s\n' "${redis_keys[@]}"
+  exit 1
+}
+for code in "${EXPECTED_THRESHOLD_CODES[@]}"; do
+  if ! redis_cmd EXISTS "threshold:${code}" | grep -q '^1$'; then
+    echo "Missing Redis threshold key: threshold:${code}"
+    exit 1
+  fi
+done
+echo "OK: all 12 threshold keys present in Redis"
+
+echo "[3/9] Verify seeded patient clinical demographics"
+seed_resp="$(request GET "${BASE_URL}/api/v1/patients?q=MRN-000001")"
+assert_status "200" "${seed_resp}"
+seed_blood="$(jq -r '.data.items[0].bloodType // empty' "${seed_resp}")"
+seed_allergies="$(jq -r '.data.items[0].allergies // empty' "${seed_resp}")"
+[[ "${seed_blood}" == "A+" ]] || { echo "Expected seeded bloodType A+, got '${seed_blood}'"; exit 1; }
+[[ "${seed_allergies}" == "Penicillin" ]] || { echo "Expected seeded allergies Penicillin, got '${seed_allergies}'"; exit 1; }
+echo "OK: seeded patient has bloodType and allergies"
+
+echo "[4/9] Register patient with clinical enrichment fields"
+patient_payload='{"firstName":"Phase10","lastName":"Verify","dateOfBirth":"1980-01-01","gender":"M","bloodType":"O+","allergies":"Penicillin","emergencyContactName":"Jane Doe","emergencyContactPhone":"555-0000"}'
+patient_resp="$(request POST "${BASE_URL}/api/v1/patients" "${patient_payload}")"
+assert_status "201" "${patient_resp}"
+patient_id="$(jq -r '.data.id' "${patient_resp}")"
+[[ "$(jq -r '.data.bloodType' "${patient_resp}")" == "O+" ]] || { echo "bloodType not returned as O+"; exit 1; }
+[[ "$(jq -r '.data.allergies' "${patient_resp}")" == "Penicillin" ]] || { echo "allergies not round-tripped"; exit 1; }
+echo "OK: patient id = ${patient_id}"
+
+echo "[5/9] Open encounter with roomBed and admissionReason"
+enc_payload='{"encounterType":"INPATIENT","department":"ICU","attendingPhysician":"Dr. Phase10","roomBed":"ICU-1A","admissionReason":"Chest pain"}'
+enc_resp="$(request POST "${BASE_URL}/api/v1/patients/${patient_id}/encounters" "${enc_payload}")"
+assert_status "201" "${enc_resp}"
+encounter_id="$(jq -r '.data.id' "${enc_resp}")"
+[[ "$(jq -r '.data.roomBed' "${enc_resp}")" == "ICU-1A" ]] || { echo "roomBed not round-tripped"; exit 1; }
+[[ "$(jq -r '.data.admissionReason' "${enc_resp}")" == "Chest pain" ]] || { echo "admissionReason not round-tripped"; exit 1; }
+echo "OK: encounter id = ${encounter_id}"
+
+recorded_at="$(date -u +"%Y-%m-%dT%H:%M:%SZ")"
+
+echo "[6/9] Ingest expanded observation codes"
+for code in "${NEW_OBSERVATION_CODES[@]}"; do
+  case "${code}" in
+    SYSTOLIC_BP)
+      value=128; unit="mmHg"; source="DEVICE" ;;
+    DIASTOLIC_BP)
+      value=82; unit="mmHg"; source="DEVICE" ;;
+    LACTATE_MMOL_L)
+      value=1.2; unit="mmol/L"; source="LAB" ;;
+    AVPU)
+      value=0; unit="score"; source="MANUAL" ;;
+    SUPPLEMENTAL_O2)
+      value=0; unit="flag"; source="MANUAL" ;;
+    *)
+      echo "Unhandled observation code ${code}"
+      exit 1
+      ;;
+  esac
+
+  obs_payload="$(jq -nc \
+    --arg code "${code}" \
+    --argjson value "${value}" \
+    --arg unit "${unit}" \
+    --arg source "${source}" \
+    --arg recordedAt "${recorded_at}" \
+    --arg key "phase10-${code}-${encounter_id}" \
+    '{observations:[{observationCode:$code,value:$value,unit:$unit,source:$source,recordedAt:$recordedAt,idempotencyKey:$key}]}')"
+  obs_resp="$(request POST "${BASE_URL}/api/v1/encounters/${encounter_id}/observations" "${obs_payload}")"
+  assert_status "201" "${obs_resp}"
+  echo "  OK: ingested ${code}"
+done
+
+echo "[7/9] Wait for Kafka relay and Elasticsearch indexer, then verify projections"
+sleep "${PIPELINE_WAIT_SECS}"
+wait_for_indexer_lag_zero
+
+for code in "${NEW_OBSERVATION_CODES[@]}"; do
+  hits="$(es_observation_hits "${code}" "${encounter_id}")"
+  [[ "${hits}" -ge 1 ]] || {
+    echo "Expected Elasticsearch observation for ${code} on encounter ${encounter_id}, found ${hits}"
+    exit 1
+  }
+  echo "  OK: Elasticsearch indexed ${code}"
+done
+
+enc_doc="$(curl -sS "${ES_URL}/patient_encounters/_source/${encounter_id}")"
+[[ "$(jq -r '.roomBed // empty' <<< "${enc_doc}")" == "ICU-1A" ]] || {
+  echo "patient_encounters document missing roomBed"
+  echo "${enc_doc}"
+  exit 1
+}
+[[ "$(jq -r '.admissionReason // empty' <<< "${enc_doc}")" == "Chest pain" ]] || {
+  echo "patient_encounters document missing admissionReason"
+  echo "${enc_doc}"
+  exit 1
+}
+echo "OK: patient_encounters document has roomBed and admissionReason"
+
+echo "[8/9] Verify GLUCOSE_MG_DL critical alert and SUPPLEMENTAL_O2 no-alert behavior"
+glucose_payload="$(jq -nc \
+  --arg recordedAt "${recorded_at}" \
+  --arg key "phase10-glucose-${encounter_id}" \
+  '{observations:[{observationCode:"GLUCOSE_MG_DL",value:35,unit:"mg/dL",source:"LAB",recordedAt:$recordedAt,idempotencyKey:$key}]}')"
+glucose_resp="$(request POST "${BASE_URL}/api/v1/encounters/${encounter_id}/observations" "${glucose_payload}")"
+assert_status "201" "${glucose_resp}"
+[[ "$(jq -r '.data.alertGenerated' "${glucose_resp}")" == "true" ]] || {
+  echo "Expected alertGenerated=true for critical glucose"
+  cat "${glucose_resp}"
+  exit 1
+}
+echo "OK: critical glucose generated alert"
+
+o2_payload="$(jq -nc \
+  --arg recordedAt "${recorded_at}" \
+  --arg key "phase10-o2-flag-${encounter_id}" \
+  '{observations:[{observationCode:"SUPPLEMENTAL_O2",value:1,unit:"flag",source:"MANUAL",recordedAt:$recordedAt,idempotencyKey:$key}]}')"
+o2_resp="$(request POST "${BASE_URL}/api/v1/encounters/${encounter_id}/observations" "${o2_payload}")"
+assert_status "201" "${o2_resp}"
+[[ "$(jq -r '.data.alertGenerated' "${o2_resp}")" == "false" ]] || {
+  echo "Expected no alert for SUPPLEMENTAL_O2 value 1"
+  cat "${o2_resp}"
+  exit 1
+}
+echo "OK: supplemental O2 flag did not generate alert"
+
+echo "[9/9] Run Phase 10 integration tests"
+dotnet test "${TEST_PROJECT}" --filter "${TEST_FILTER}"
+
+echo
+echo "Phase 10 verification checks passed."