Additional awards of the medal are denoted by gold or silver 5/16 inch stars.

Subsequant awards are denoted with bronze and silver service stars.

Additional awards are denoted with 5/16 inch gold star devices.

Additional awards of the decoration were denoted by gold award stars.

Subsequent awards are denoted by bronze and silver service stars.

Each subsequent award is denoted by a bar with the date of bestowal on the ribbon.

Additional awards of the ribbon are denoted by bronze and silver service stars.

Further awards of this decoration were denoted by a silver rose emblem.

After 1921, multiple awards were denoted by service stars.

Multiple awards of the ribbon are denoted by service stars.