CREST THE GREAT LAB (TGL) GRAND DESIGN CHALLENGE APPLICATION FORM

APPLICATION FORM
One (1) hardcopy and softcopy (email : thegreatlab@crest.my) of this form must be submitted to the
Collaborative Research in Engineering, Science & Technology (CREST) Center, Research & Development
Division, Block C, Ground Floor, sains@usm, No. 10 Persiaran Bukit Jambul, 11900 Bayan Lepas, Penang,
Malaysia. (http://www.crest.my)

[Incomplete Applications will not be reviewed]

DETAILS OF PROJECT LEADER

Name of Project Leader (as per IC or passport): Aiman Fitri Bin Yusoff

Home No:

Mobile No.: 012-3240329

E-mail Address: igori76@gmail.com

Mailing Address: MRSM Alor Gajah, Lot 1720 Mukim Ayer Paabas, 78000 Alor Gajah, Melaka

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CREST THE GREAT LAB (TGL) GRAND DESIGN CHALLENGE APPLICATION FORM

PROJECT TEAM MEMBERS:

(including Project Leader)

Original
Team
No Name School Form Email Signature
Member
(Yes/No)
1. Nur Batrysha Bt Fazi Amar MRSM Alor 2 yes
Gajah
2. Batrisyia Bt Zumli MRSM Alor 1 yes
Gajah
3.
4.
5.

TEAM INFORMATION

Previous Participation in CREST Talent Event (Please mark ☒ ):

☐ Event
☐ The Great Lab Summer Workshop (21st till 24th July 2016)
☐ Medical Devices Cluster Bootcamp (28th till 31st July 2016)
☐ Semiconductor & Optoelectronics Cluster Bootcamp (11th till 14th August 2016)
☒ Youth Industry Bootcamp Central (4th till 7th August 2016)
☐ Youth Industry Bootcamp Northern (19th till 21st August 2016)

☐ Track
☐ Track 1 (Arduino)
☐ Track 2 (Arduino)
☒ Track 3 (RERO)
☐ Track 4 (3D Printing)

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CREST THE GREAT LAB (TGL) GRAND DESIGN CHALLENGE APPLICATION FORM

PROJECT SUPERVISOR INFORMATION

Full Name (as per IC or passport): Mohamad Rizal Bin Mukhtar

Designation/Position Title: Teacher

University/ School: MRSM Alor Gajah

Faculty:

Address: MRSM Alor Gajah, Lot 1720 Mukim Ayer Paabas, 78000 Alor Gajah, Melaka

Note:
(1) If more than one project supervisor is involved, please provide information about the
primary supervisor and include information on the other supervisors in attachments.

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CREST THE GREAT LAB (TGL) GRAND DESIGN CHALLENGE APPLICATION FORM

PROJECT INFORMATION

A Title of proposed project : THE HOSPITAL HELPER

B Executive Summary of Project Proposal (maximum 300 words)

(Please include brief explanation on the problem statement and scope of the proposed
project)

One problem we face in the medical world today is that most facilities are
overcrowded and the staff are overworked. More often than not, doctors and nurses
have to extend their hours because of the overflow of patients at the hospital.
We would like to put an end to the problem by presenting, THE HOSPITAL HELPER.
A robot designed to help nurses and doctors ease their workflow in the hospital. The
robot is to give sufficient assistance to patients and doctors alike. A reconfigurable
robot that is designed to help doctors in hospitals. It is equipped with a sterilizing
feature and a tray on its back to bring medicine and medical reports back and forth
between doctors and patients in the ward. It is also equipped with child-friendly
features such as soft sponges on
hands of the robot.

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CREST THE GREAT LAB (TGL) GRAND DESIGN CHALLENGE APPLICATION FORM

C DETAILED PROPOSAL OF PROJECT:

C(i) Project background including problem statement and research methodology.

Problem Statement: Hospitals are overcrowded and the staff are overworked and not
paid as much as they should be.

Research methodology: -List down all the possible solutions for this problem.
-State the target for this projects (clinics,hospitals,homes)
-Design the product by using RERO and test it.

C(ii) Objective(s) of the Project

This project embarks on the following objectives:

1) To develop a robot that can help hospital staffs

2) To ease the flow of work at a hospital
3) All patients get complete medical healthcare with no hiccups.

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CREST THE GREAT LAB (TGL) GRAND DESIGN CHALLENGE APPLICATION FORM

C(iii) Proposed Project Plan (by weekly basis)

1. Project Scope

Hospitals, Clinics, of people who need medical care

2. Flow Chart of Project Activities

Please refer Appendix below

3. Gantt Chart of Project Activities including Milestones and Dates

Please refer Appendix below

4. Human Resources Plan (Team composition, roles and responsibilities, etc.)

Name of Members School Roles Responsibilities

En. Nik Hafizul KKTM Ledang Advisor Consultation
Hasmie

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CREST THE GREAT LAB (TGL) GRAND DESIGN CHALLENGE APPLICATION FORM

C(iv) Expected Outcome of the Project

1. Describe the Technology Readiness level of the output. Please select one of the
boxes below.

☐ Prototype ready for demonstration in an appropriate operational

environment
☐ System/subsystem model or prototype demonstration in a simulated
environment

Detailed Explanation of the Expected Outcome

C(v) Marketability Aspect

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CREST THE GREAT LAB (TGL) GRAND DESIGN CHALLENGE APPLICATION FORM

D Bill of Materials and Budget

Please indicate your estimated budget for this project as below.

i.
No. Raw Materials/Components Cost (RM)

1 Lego Standard Kit RM100

2 sponges RM10
3 Cube servo 99
4 Rotate connect and interconnect 3&4

ii. Indicate
No. Equipment/Software Purchase
Cost (RM)
/Rental
1 RERO RERO sponsored
2
3
4

iii. No.
Other Cost (travel, transport, accommodation, etc.) Cost (RM)
1 Transport (fuel, Toll) using van (lumpsum) 175
2 Accomodation – rent a budget hotel – 100 per night for 2 200
rooms
3
4

TOTAL COST : RM__________

Note:
(1) In the event that any project materials, equipment, software or other project
items are sponsored/contributed by any party/parties or already owned by project
team members/universities/schools, please list the item and specify the cost as
SPONSORED ..(by whom).
(2) Purchase or rental of any items stated in the above budget must be supported
with original receipts.

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CREST THE GREAT LAB (TGL) GRAND DESIGN CHALLENGE APPLICATION FORM

F Declaration by applicants
(Please tick ( √ )):

I hereby declare that:

☒ 1. All information stated here are accurate. CREST has the right to reject or to
cancel the offer without prior notice if there is any inaccurate information given.

☐ 2. Signed PDPA Consent Forms for every team members are attached in this

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CREST THE GREAT LAB (TGL) GRAND DESIGN CHALLENGE APPLICATION FORM

application.

Date : Project Leader’s Signature :

Note:
Application submitted will be treated in full confidence. The award decision is final.

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CREST THE GREAT LAB (TGL) GRAND DESIGN CHALLENGE APPLICATION FORM

CHECKLIST FOR CREST THE GREAT LAB (TGL) GRAND DESIGN

CHALLENGE APPLICATION FORM

1) One (1) set of hardcopy CREST TGL Grand Design Challenge ☐

Application Form
2) One (1) set of softcopy CREST TGL Grand Design Challenge ☐
Application Form
3) Project Proposal (in Powerpoint) ☐
4) Curriculum Vitae of Project Team Members (for university students) ☐
5) CREST PDPA Consent form for every project team members. ☐
6) Support Letter from Project Supervisor (upon approval) ☐
7) Project Leader’s copy of IC and bank account details (upon approval) ☐

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