admin"and/**/extractvalue(1,concat(char(126),md5(1173113739)))and"
123456
123456
123456
Doctor's Signature
..................................
123456
123456
Patient's Signature
..................................
admin"and/**/extractvalue(1,concat(char(126),md5(1173113739)))and"
admin"and/**/extractvalue(1,concat(char(126),md5(1173113739)))and"