diff --git a/src/components/call-desk/appointment-form.tsx b/src/components/call-desk/appointment-form.tsx
index 53bdc77..7eead57 100644
--- a/src/components/call-desk/appointment-form.tsx
+++ b/src/components/call-desk/appointment-form.tsx
@@ -259,6 +259,25 @@ export const AppointmentForm = ({
                 );
                 notify.success('Appointment Updated');
             } else {
+                // If no patient record exists yet (new caller), create one now
+                let resolvedPatientId = patientId;
+                if (!resolvedPatientId && callerNumber) {
+                    const trimmedName = patientName.trim();
+                    const nameParts = {
+                        firstName: trimmedName.split(' ')[0] || 'Unknown',
+                        lastName: trimmedName.split(' ').slice(1).join(' ') || '',
+                    };
+                    try {
+                        const created = await apiClient.graphql<{ createPatient: { id: string } }>(
+                            `mutation($data: PatientCreateInput!) { createPatient(data: $data) { id } }`,
+                            { data: { fullName: nameParts, phones: { primaryPhoneNumber: callerNumber }, patientType: 'NEW' } },
+                        );
+                        resolvedPatientId = created.createPatient.id;
+                    } catch (err) {
+                        console.warn('Failed to create patient:', err);
+                    }
+                }
+
                 // Create appointment
                 await apiClient.graphql(
                     `mutation CreateAppointment($data: AppointmentCreateInput!) {
@@ -274,7 +293,7 @@ export const AppointmentForm = ({
                             department: selectedDoctor?.department ?? '',
                             doctorId: doctor,
                             reasonForVisit: chiefComplaint || null,
-                            ...(patientId ? { patientId } : {}),
+                            ...(resolvedPatientId ? { patientId: resolvedPatientId } : {}),
                         },
                     },
                 );
diff --git a/src/pages/call-desk.tsx b/src/pages/call-desk.tsx
index 64476b8..4db54f9 100644
--- a/src/pages/call-desk.tsx
+++ b/src/pages/call-desk.tsx
@@ -91,7 +91,7 @@ export const CallDeskPage = () => {
             .then((result) => {
                 setResolvedCaller(result);
                 if (result.isNew) {
-                    notify.info('New Caller', 'Lead and patient records created');
+                    notify.info('New Caller', 'No existing records found for this number');
                 }
             })
             .catch((err) => {