Holes are punched (redefined, if following original stitching) in the text block, at the marks, using an awl, biological dissection probe, or similar tool.

Note: The tool in the illustration is a sculptor's needle tool. It has been wrapped with cotton twine because it has a rather sharp shoulder at the base of the point, which is somewhat prone to tearing paper when used for the purpose shown. The twine wrapping proved effective in eliminating this concern.