diff --git a/src/clients/db/PageRequest.ts b/src/clients/db/PageRequest.ts
index 447205bc39..065f80f66b 100644
--- a/src/clients/db/PageRequest.ts
+++ b/src/clients/db/PageRequest.ts
@@ -1,8 +1,12 @@
 export default interface PageRequest {
   number: number | undefined
   size: number | undefined
+  nextPageInfo: { [key: string]: string | null } | undefined
+  direction: 'previous' | 'next' | null
 }
 export const UnpagedRequest: PageRequest = {
   number: undefined,
   size: undefined,
+  nextPageInfo: undefined,
+  direction: null,
 }
diff --git a/src/clients/db/PatientRepository.ts b/src/clients/db/PatientRepository.ts
index 6e7bbc753e..5f6cb1e552 100644
--- a/src/clients/db/PatientRepository.ts
+++ b/src/clients/db/PatientRepository.ts
@@ -15,7 +15,7 @@ export class PatientRepository extends Repository<Patient> {
   constructor() {
     super(patients)
     patients.createIndex({
-      index: { fields: ['fullName', 'code'] },
+      index: { fields: ['index'] },
     })
   }
 
@@ -86,6 +86,7 @@ export class PatientRepository extends Repository<Patient> {
   async save(entity: Patient): Promise<Patient> {
     const patientCode = getPatientCode()
     entity.code = patientCode
+    entity.index = (entity.fullName ? entity.fullName : '') + patientCode
     return super.save(entity)
   }
 }
diff --git a/src/clients/db/Repository.ts b/src/clients/db/Repository.ts
index cde7100407..3cdcf75191 100644
--- a/src/clients/db/Repository.ts
+++ b/src/clients/db/Repository.ts
@@ -47,27 +47,59 @@ export default class Repository<T extends AbstractDBModel> {
     const selector: any = {
       _id: { $gt: null },
     }
-
-    sort.sorts.forEach((s) => {
-      selector[s.field] = { $gt: null }
-    })
+    if (pageRequest.direction === 'next') {
+      sort.sorts.forEach((s) => {
+        selector[s.field] = {
+          $gte:
+            pageRequest.nextPageInfo && pageRequest.nextPageInfo[s.field]
+              ? pageRequest.nextPageInfo[s.field]
+              : null,
+        }
+      })
+    } else if (pageRequest.direction === 'previous') {
+      sort.sorts.forEach((s) => {
+        s.direction = s.direction === 'asc' ? 'desc' : 'asc'
+        selector[s.field] = {
+          $lte:
+            pageRequest.nextPageInfo && pageRequest.nextPageInfo[s.field]
+              ? pageRequest.nextPageInfo[s.field]
+              : null,
+        }
+      })
+    }
 
     const result = await this.db.find({
       selector,
       sort: sort.sorts.length > 0 ? sort.sorts.map((s) => ({ [s.field]: s.direction })) : undefined,
-      limit: pageRequest.size,
-      skip:
-        pageRequest.number && pageRequest.size ? (pageRequest.number - 1) * pageRequest.size : 0,
+      limit: pageRequest.size ? pageRequest.size + 1 : undefined,
+      skip: pageRequest.direction === 'previous' ? pageRequest.size : undefined,
     })
     const mappedResult = result.docs.map(mapDocument)
 
+    if (pageRequest.direction === 'previous') {
+      mappedResult.reverse()
+    }
+    const nextPageInfo: { [key: string]: string } = {}
+
+    if (mappedResult.length > 0) {
+      sort.sorts.forEach((s) => {
+        nextPageInfo[s.field] = mappedResult[mappedResult.length - 1][s.field]
+      })
+    }
+
     const pagedResult: Page<T> = {
-      content: mappedResult,
-      hasNext: pageRequest.size !== undefined && mappedResult.length === pageRequest.size,
-      hasPrevious: pageRequest.number !== undefined && pageRequest.number > 1,
+      content:
+        pageRequest.size !== undefined && mappedResult.length === pageRequest.size + 1
+          ? mappedResult.slice(0, mappedResult.length - 1)
+          : mappedResult,
+      hasNext: pageRequest.size !== undefined && mappedResult.length === pageRequest.size + 1,
+      // hasPrevious: pageRequest.number !== undefined && pageRequest.number > 1,
+      hasPrevious: false,
       pageRequest: {
         size: pageRequest.size,
         number: pageRequest.number,
+        nextPageInfo,
+        direction: null,
       },
     }
     return pagedResult
diff --git a/src/model/Patient.ts b/src/model/Patient.ts
index 27fde51a46..972492c24d 100644
--- a/src/model/Patient.ts
+++ b/src/model/Patient.ts
@@ -18,4 +18,5 @@ export default interface Patient extends AbstractDBModel, Name, ContactInformati
   allergies?: Allergy[]
   diagnoses?: Diagnosis[]
   notes?: Note[]
+  index: string
 }
diff --git a/src/patients/edit/EditPatient.tsx b/src/patients/edit/EditPatient.tsx
index 350a3f2bdd..1e642ded64 100644
--- a/src/patients/edit/EditPatient.tsx
+++ b/src/patients/edit/EditPatient.tsx
@@ -73,6 +73,8 @@ const EditPatient = () => {
         {
           ...patient,
           fullName: getPatientName(patient.givenName, patient.familyName, patient.suffix),
+          index:
+            getPatientName(patient.givenName, patient.familyName, patient.suffix) + patient.code,
         },
         onSuccessfulSave,
       ),
diff --git a/src/patients/list/ViewPatients.tsx b/src/patients/list/ViewPatients.tsx
index 9e34fb79f9..fdced50eb7 100644
--- a/src/patients/list/ViewPatients.tsx
+++ b/src/patients/list/ViewPatients.tsx
@@ -28,6 +28,8 @@ const ViewPatients = () => {
   const [userPageRequest, setUserPageRequest] = useState<PageRequest>({
     size: 1,
     number: 1,
+    nextPageInfo: { index: null },
+    direction: 'next',
   })
 
   const setNextPageRequest = () => {
@@ -36,6 +38,8 @@ const ViewPatients = () => {
         const newPageRequest: PageRequest = {
           number: p.number + 1,
           size: p.size,
+          nextPageInfo: patients.pageRequest?.nextPageInfo,
+          direction: 'next',
         }
         return newPageRequest
       }
@@ -49,6 +53,8 @@ const ViewPatients = () => {
         return {
           number: p.number - 1,
           size: p.size,
+          nextPageInfo: patients.pageRequest?.nextPageInfo,
+          direction: 'previous',
         }
       }
       return p
@@ -60,20 +66,14 @@ const ViewPatients = () => {
 
   useEffect(() => {
     const sortRequest: SortRequest = {
-      sorts: [
-        { field: 'fullName', direction: 'asc' },
-        { field: 'code', direction: 'asc' },
-      ],
+      sorts: [{ field: 'index', direction: 'asc' }],
     }
     dispatch(searchPatients(debouncedSearchText, sortRequest, userPageRequest))
   }, [dispatch, debouncedSearchText, userPageRequest])
 
   useEffect(() => {
     const sortRequest: SortRequest = {
-      sorts: [
-        { field: 'fullName', direction: 'asc' },
-        { field: 'code', direction: 'asc' },
-      ],
+      sorts: [{ field: 'index', direction: 'asc' }],
     }
     dispatch(fetchPatients(sortRequest, userPageRequest))