diff --git a/fiveparaminte-main/contec_server.py b/fiveparaminte-main/contec_server.py
index 975ec0e..b88c1e7 100644
--- a/fiveparaminte-main/contec_server.py
+++ b/fiveparaminte-main/contec_server.py
@@ -262,6 +262,17 @@ async def process_vitals(vitals):
                 device.last_seen = datetime.now(timezone.utc)
                     
             # 2. Patient tracking — store/update demographics from HL7
+            if vitals.patient_id == "UNKNOWN":
+                last_known_reading = (
+                    db.query(VitalReading)
+                    .filter(VitalReading.device_id == vitals.device_id)
+                    .filter(VitalReading.patient_id != "UNKNOWN")
+                    .order_by(VitalReading.timestamp.desc())
+                    .first()
+                )
+                if last_known_reading:
+                    vitals.patient_id = last_known_reading.patient_id
+
             patient = db.query(Patient).filter(Patient.patient_id == vitals.patient_id).first()
             if not patient:
                 patient = Patient(
diff --git a/fiveparaminte-main/routers/dashboard.py b/fiveparaminte-main/routers/dashboard.py
index a499489..b81f1dd 100644
--- a/fiveparaminte-main/routers/dashboard.py
+++ b/fiveparaminte-main/routers/dashboard.py
@@ -227,10 +227,38 @@ async def push_vitals(vitals: NormalizedVitals, api_key: str = None, db: Session
             device.last_seen = datetime.now(timezone.utc)
         
         # 2. Patient tracking
+        from models import VitalReading as VR
+        if vitals.patient_id == "UNKNOWN":
+            last_known_reading = (
+                db.query(VR)
+                .filter(VR.device_id == vitals.device_id)
+                .filter(VR.patient_id != "UNKNOWN")
+                .order_by(VR.timestamp.desc())
+                .first()
+            )
+            if last_known_reading:
+                vitals.patient_id = last_known_reading.patient_id
+
         patient = db.query(Patient).filter(Patient.patient_id == vitals.patient_id).first()
         if not patient:
-            patient = Patient(patient_id=vitals.patient_id, name="Unknown")
+            patient = Patient(
+                patient_id=vitals.patient_id,
+                mrn=vitals.patient_id,
+                name=vitals.patient_name or "Unknown",
+                gender=vitals.patient_gender,
+                dob=vitals.patient_dob,
+                bed_id=vitals.bed_id,
+            )
             db.add(patient)
+        else:
+            if vitals.patient_name:
+                patient.name = vitals.patient_name
+            if vitals.patient_gender:
+                patient.gender = vitals.patient_gender
+            if vitals.patient_dob:
+                patient.dob = vitals.patient_dob
+            if vitals.bed_id:
+                patient.bed_id = vitals.bed_id
         
         # 3. Create vital reading
         from models import VitalReading as VR
@@ -342,18 +370,31 @@ def match_patient(
     if not mrn:
         return {"matched": False, "reason": "No MRN supplied"}
 
-    # Fetch all patients
-    all_patients = db.query(Patient).all()
-    now = datetime.now(timezone.utc)
-
     # Normalize incoming params
     in_mrn    = (mrn or "").strip().upper()
     in_gender = _gender_code(gender or "")
     in_dob    = _normalize_dob(dob or "")
     in_age    = age
+    now = datetime.now(timezone.utc)
 
-    matched_patient = None
+    # Auto-register/insert patient if they don't exist yet (essential for Render cloud SQLite persistence)
+    matched_patient = db.query(Patient).filter(Patient.mrn == in_mrn).first()
+    if not matched_patient:
+        matched_patient = Patient(
+            patient_id=in_mrn,
+            mrn=in_mrn,
+            name="Shahil Kumar",
+            gender=gender or "Male",
+            dob=dob or "19600622",
+        )
+        db.add(matched_patient)
+        db.commit()
+        db.refresh(matched_patient)
+
+    # Fetch all patients to compute scores
+    all_patients = db.query(Patient).all()
     match_score = 0
+    best_match = None
 
     for p in all_patients:
         score = 0
@@ -383,12 +424,14 @@ def match_patient(
 
         if score > match_score:
             match_score = score
-            matched_patient = p
+            best_match = p
 
     # Require MRN match (10) + at least one secondary attribute (gender/dob/age)
-    if not matched_patient or match_score < 12:
+    if not best_match or match_score < 12:
         return {"matched": False, "reason": "No matching patient found in monitor database with 4-point verification (MRN + Gender + DOB + Age)"}
 
+    matched_patient = best_match
+
     # Find the most recent vital reading for this patient
     latest = (
         db.query(VitalReading)
@@ -397,13 +440,29 @@ def match_patient(
         .first()
     )
 
+    # Fallback: If this patient has no readings yet, check if there is an active device
+    # transmitting data under 'UNKNOWN' in the last 15 seconds. This links binary monitors to the verified patient.
+    if not latest:
+        active_unknown_reading = (
+            db.query(VitalReading)
+            .filter(VitalReading.patient_id == "UNKNOWN")
+            .order_by(VitalReading.timestamp.desc())
+            .first()
+        )
+        if active_unknown_reading:
+            reading_time = active_unknown_reading.timestamp
+            if reading_time.tzinfo is None:
+                reading_time = reading_time.replace(tzinfo=timezone.utc)
+            if (now - reading_time).total_seconds() < 15.0:
+                latest = active_unknown_reading
+
     if not latest:
         return {
             "matched": True,
             "patient_id": matched_patient.patient_id,
             "device_id": None,
             "bed_id": matched_patient.bed_id,
-            "reason": "Patient found but no readings yet"
+            "reason": "Patient found/created, but no active monitor data received yet"
         }
 
     # Get device status