Answer :

Tengo (una cita) con el médico a las cuatro de la tarde.
Translation:
I have an appointment with the doctor at 4 p.m.

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Rewritten by : Barada

The answer is una cita.

The sentence reads “I have (blank) with the doctor at 4 in the afternoon” and the choices are:
un resfriado-a cold
una pastilla-a pill
una cita-an appointment
una tos-a cough

Una cita is the only choice that makes sense.