How can i change existing column as Identity in PostgreSQL 11.1

Suppose you have a table patient previously created as

CREATE TABLE patient( patientid int, col1 int );

and a row inserted as

INSERT INTO patient VALUES(1,5);

Firstly create a sequence starting +1 iterated from the max value of ID and make it default for your column

CREATE SEQUENCE mySeq START WITH 2;
ALTER TABLE patient ALTER COLUMN patientid SET DEFAULT nextval('mySeq');

and convert your column to a primary key

ALTER TABLE patient ALTER COLUMN patientid SET NOT NULL;
ALTER TABLE patient ADD CONSTRAINT uk_patientid UNIQUE (patientid);

whenever you insert new rows such as

INSERT INTO patient(col1) VALUES(10);
INSERT INTO patient(col1) VALUES(15);

you'll observe that you sucessfully made your column as an identity column

SELECT * FROM patient

patientid  col1
---------  ----
1          5
2          10
3          15

Following the documentation

ALTER TABLE patient 
    ALTER patientid SET NOT NULL,  -- optional
    ALTER patientid ADD GENERATED ALWAYS AS IDENTITY 
        (START WITH 2);  -- optional

Add NOT NULL constraint if the column does not have the constraint yet. The optional clause START WITH start changes the recorded start value of the sequence.

Test it in DB<>Fiddle.