CPGS-RD-7

Centre of Postgraduate Studies

Wisma Lincoln
No. 12-18, Jalan SS6/12, Off Jalan Perbandaran
47301 Petaling Jaya, Selangor, Malaysia

CANDIDATE'S DECLARATION FORM

(This form should be submitted to Postgraduate Study Committee with the candidate's thesis)

1 THE CANDIDATE

Name: Sumedi Student ID: 01311805180

Faculty/Department: Faculty of Nursing Intake: January 2017
Title of research project: INFLUENCE OF "MEASURABLE EXERCISE METHOD" IN PREVENTING EXACERBATIONS
IN PATIENTS WITH COPD AT PERSAHABATAN HOSPITAL JAKARTA

2 STATEMENT OF ADVANCED STUDIES UNDERTAKEN IN CONNECTION WITH THE PROGRAMME OF RESEARCH

3 DETAILS OF RESEARCH PROGRAMME

*I declare that, while registered as a candidate for a Research Degree, I have not been a registered candidate or enrolled
student for another award.

Signature Date 19 October 2020

*I declare that, while registered as a candidate for a Research Degree, I was, with the University's permission a
registered candidate / enrolled for another award.

Signature Date 19 October

2020

4 DECLARATION OF CANDIDATE

I confirm that the thesis submitted is the outcome of the work that I have undertaken during my programme of study
and is all my own work.

Signature Date 19 October 2020

5 SUPERVISOR ACKNOWLEDGEMENT

Signature Date

Approved by Director CPGS