What a very special lady to give you such a special gift. The quilt is quite lovely.
As for the small hole I think I would first stitch around it to prevent it ripping and further. Then I would embroider a label stating you received this quilt on your birthday from so-and-so in the year such-and-such. Then I'd attach the label over the hole and hide it! It's not the perfect solution but I tend to go for the quick and easy.
Meanwhile, enjoy that beautiful piece of art.