Confirmed empirically: the SAME clinical document (identical FHIR Bundle.id) gets re-delivered by the bridge under a DIFFERENT transaction_id/consent_ref every time it is re-fetched (e.g. via the by-ABHA-address historical fetch, which returns every past consent session for the patient). The old dedup hash included transaction_id+consent_ref, so every re-fetch created a brand-new duplicate row instead of updating the existing one -- observed as literal duplicate rows in the OPD ABDM Fetched Data list (same date/title appearing 2-3x). bundle_id is set once by the HIP and is stable across re-fetches/consents, so pair it with care_context_reference to uniquely identify a document instead.
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