INDIAN INSTITUTE OF TECHNOLOGY GANDHINAGAR
Application Form for Admission to Doctoral Programme
                       Ph.D. Program in:             Biological Sciences
Disciplines: Chemical Engineering, Chemistry, Civil Engineering, Cognitive Science,                                         Paste passport
Computer Science and Engineering, Electrical Engineering, English, Mechanical Engineering,                                  size photograph
Materials Science & Engineering, Mathematics, Physics, Philosophy, Psychology, Sociology
Research Areas of Interest:          (Please refer to Faculty Research Profiles at www.iitgn.ac.in/phd.htm)
Identification of shared druggable target in neurodegenerative disorders
Name (as in qualifying degree certificate)
   First Name           P       U       N        I        T       K       U      M         A      R
  Middle Name           R       A       M        E        S       H       C      H         A      N       D       R       A
   Last Name            B       H       A        T        T
Contact details
 Address for communication:                                                Permanent Address:
 Block No. 21/B, “Matruchhaya”, Suryanagar, Nr. Noble                      Block No. 21/B, “Matruchhaya”, Suryanagar, Nr. Noble
 School, B/H S. T. Bus stand,                                              School, B/H S. T. Bus stand,
                               Pin                                                                              Pin
 City: Junagadh                              3   6    2       0   0   1    City: Junagadh                                  3    6    2    0    0    1
                               Code                                                                             Code
 State: Gujarat                                                            State: Gujarat
 Telephone Number                Mobile Number                        Email Address: punitbhatt85@gmail.com
                                 +91-9033546890
                                                                      Alternate Email Address: puns003@gmail.com
       Date of Birth                         Nationality                      Gender                    Category: GN/OBC/SC/ST/PD
    13th October, 1985                         Indian                          Male                               General
Category under which you want to apply (Please check appropriate box)
   Regular (RR):                     Start Early (RR):                 External (ET): Candidates                   Faculty Development
   Fulltime residential              Fulltime residential              serving in research                         Program (FDP): Candidates
   researcher                        researcher                        institution/Industry**                      serving in educational
   candidate                         candidate*                                                                    Institutions only**
*All Start early (RR) applications must include signed letter/certificate from head of department indicating rank of the candidate at the end of 6
semesters
**All ET/FDP applications must include employer’s support/sponsorship letter
Rank in your discipline after 6 semesters in BTech/BE programme (For Start Early (RR) category)
                                    Must be supported by a signed letter/certificate from the head of the department stating the rank of the candidate
GATE/UGC-NET/CSIR-UGC performance
            Name of Examination                               Year                 Score                 Percentile              All India Rank
                                                                                                                                      (AIR)
                     GATE                                     2009                   370                      87.74                    2968
Details of academic record (From 12th onwards for Start early (RR) and Bachelors onwards for Regular (RR), ET and FDP)
                                                                 University/        Year of          Class/       % of Marks/Grade
   Degree              Subject               College
                                                                  Institute         Passing         Division           /CGPA
                                          B. K. Mody
  Diploma in                                                     Saurashtra
                    PHARMACY            Govt. Pharmacy                                2005           Pass                 56%
  Pharmacy                                                       University
                                        College, Rajkot
                                         N R Vekaria
 Bachelor in                              College of             Saurashtra
                    PHARMACY                                                          2009           First               67.84%
 Pharmacy                                 Pharmacy,              University
                                          Junagadh
                                            Dept of
                                        Pharmaceutical
  Master in                               Sciences,              Saurashtra
                 PHARMACOGNOSY                                                        2011           First             7.49 CPI
  Pharmacy                                Saurashtra             University
                                          University,
                                            Rajkot
Details of Any Research/Professional Experience or Publication
 I have been working as Visiting Lecturer in Department of Pharmaceutical Sciences, Saurashtra University, Rajkot
  since September, 2011. I am working for lectures, practical, research work of PG students.
 I have attended more than 14 national and international seminars, workshops, conferences and presented poster
  in that also.
 My dissertation of M Pharm. was sponsored by Govt. of Gujarat under Student SciTech Project of GUJCOST.
Research Publications:
 Bhatt PR, Pandya KB, Sheth NR (2010). Camellia sinensis- A medicinal beverage. Int J Pharm Sci Rev Res 3 (2):
   6-9.
 Shah R, Bhatt PR, Parmar SK, Chanda SV (2011). Hepatoprotective activity of ethyl acetate fraction of Tephrosia
   purpurea. Pharmacologyonline 3: 188-194.
Conference Proceedings:
 Punit Bhatt et al., Proceeding of International Conference of Ethnopharmacology, Jadavpur University, Kolkata.
    Poster Presentation SNPSJU0300, 17th to 19th February, 2012.
 Punit Bhatt et al., Proceedings of 14th National Convention of Society of Pharmacognosy. Hindu College of
    Pharmacy, Haryana. Poster Presentation PP 196, Feb. 20th &21st 2010.
 Dhruv Ramanuj, Punit Bhatt, Navin Sheth. Abstract published in Pharma Science Monitor Journal. Poster
    Presentation at 16th National Convention of Society of Pharmacognosy and International Symposium.
 Dhara Pathak, Punit Bhatt* et al., Abstract published in Pharma Sciences Monitor Journal. Poster Presentation at
    16th National Convention of Society of Pharmacognosy and International Symposium.
Details of any past employment
                                                                                                       Duration
                 Organization                             Designation
                                                                                             From                         To
Department of Pharmaceutical                     Visiting Lecturer               September, 2011               Till date
Sciences, Saurashtra University,                                                                               (1 year total)
Gujarat
Declaration:
1. I have carefully read the web-advertisement and the faculty research profiles uploaded on the web
2. The SOP submitted with the application form was written only by me.
3. I hereby declare that the information given above is correct to the best of my knowledge and belief. I am also aware
that providing incorrect information in the application form can result in the cancellation of my admission at any stage.
Place: Junagadh
Date: 07/09/2012                                                                                               Punit R Bhatt
Check List for Enclosures:
         Copy of Mark sheets / Grade cards (From 12th onwards for start early and Bachelors onwards for RR,ET and FDP)
         Statement of purpose
         Copy of GATE score/UGC-NET/CSIR-UGC (if applicable)
         Copy of Certificate of SC/ST/OBC (if applicable)
         Signed letter/certificate from head of department indicating rank of the candidate at the end of 6
         semesters (in case of Start early Program candidates)
         Employer’s support/sponsorship letter (in case of External/Faculty Development Program candidates)