- Add turno_id column to rips_examenes_pendientes (already migrated) - Filter turno_id IS NULL in get_examenes_rips.php query - New marcar_rips_usado.php marks record as consumed when loaded - cargarExamenesRips() calls marker after loading exams into the turn Co-Authored-By: Claude Sonnet 4.6 <noreply@anthropic.com>