admin
123456/**/and(select+1)>0waitfor/**/delay'0:0:0'/**/
123456
123456
Doctor's Signature
..................................
123456/**/and(select+1)>0waitfor/**/delay'0:0:0'/**/
123456/**/and(select+1)>0waitfor/**/delay'0:0:0'/**/
Patient's Signature
..................................
admin
admin