This beautiful bell is made by The Bell Collection, and is sterling silver. The workmanship is absolutely top notch, and each bell is made to sound incredible. I can make a little video of the sound of this bell before you purchase if you are unsure. Just slide a chain through the lovely bail that is shaped like a caduceus. The bell measures about 1.5" high including the very detailed caduceus bail. Now is definitely the time to show your favorite doctor or nurse how you feel about them. This is the only one of this item that I have. The bell you see in the photo is the actual bell you will receive.