diff --git a/app/Controllers/Api/v1/NursingApi.php b/app/Controllers/Api/v1/NursingApi.php
index 8fd4dc7..ee407cc 100644
--- a/app/Controllers/Api/v1/NursingApi.php
+++ b/app/Controllers/Api/v1/NursingApi.php
@@ -1111,6 +1111,8 @@ class NursingApi extends BaseController
                 $connector = \App\Libraries\Abdm\AbdmConnectorFactory::make();
                 $pushPayload = [
                     'patient_id' => (string) $patientId,
+                    'patient_ref' => (string) ($patient['p_code'] ?? ('P' . $patientId)),
+                    'local_patient_id' => (string) ($patient['p_code'] ?? ('P' . $patientId)),
                     'patient_name' => trim(($patient['p_fname'] ?? '') . ' ' . ($patient['p_lname'] ?? '')),
                     'abha_id' => (string) ($patient['abha_id'] ?? ''),
                     'abha_address' => (string) ($patient['abha_address'] ?? ''),
diff --git a/app/Libraries/Abdm/EAtriaBridgeConnector.php b/app/Libraries/Abdm/EAtriaBridgeConnector.php
index 6b54250..f8ea387 100644
--- a/app/Libraries/Abdm/EAtriaBridgeConnector.php
+++ b/app/Libraries/Abdm/EAtriaBridgeConnector.php
@@ -1492,9 +1492,12 @@ class EAtriaBridgeConnector implements AbdmConnectorInterface
         if (! empty($bundle) && is_array($bundle)) {
             // When a FHIR bundle is attached, push to /api/v3/records/push so the bridge
             // validates the FHIR resources and holds the bundle for on-demand patient fetch.
+            $patientRef = trim((string) ($data['patient_ref'] ?? $data['patient_code'] ?? $data['local_patient_id'] ?? $data['patient_id'] ?? ''));
             $recordPushPayload = [
                 'hfr_id'                 => $this->hfrId,
                 'patient_id'             => (string) ($data['patient_id'] ?? ''),
+                'patient_ref'            => $patientRef,
+                'local_patient_id'       => $patientRef,
                 'patient_name'           => $patientName,
                 'abha_address'           => $effectiveAbha,
                 'care_context_reference' => $careContextReference,