The original meaning of punctual described a puncture made by a surgeon. The word has meant lots of other things through the centuries, usually involving being precise about small points. And today punctuality is all about time; a punctual train or a punctual payment or a punctual person shows up "on the dot".
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Middle English, having a sharp point, from Medieval Latin punctualis of a point, from Latin punctus pricking, point, from pungere to prick — more at pungent