Martin Yale 525M Master Hole Punch, 11/32" Hole Diameter, Punches Through Up To 40 Sheets of 20-lb. Bond Paper, Comes With 5 Punch Heads and Accepts a Total of 7 Ideal for use in hospital administrative offices, nurse's stationis, doctor offices and other medical related areas Adjustable to handle 3, 5, or 7 hole punching for special forms used in the medical profession Lever handle provides easy punching Punches through up to 40 sheets of 20-lb. bond paper (when using 3-hole) Comes with 5 punch heads, but accepts 7