You are looking at the Medal for Life Saving by Tsar Nicholas II. The Medal was first instituted on April 17, 1828. After the death of Tsar Alexander III, the Medal was reissued around 1894 wearing the semblance of the new Sovereign, Tsar Nicholas II. The Medal were bestowed upon individuals for deeds involving saving lives.
The obverse of the Medal shows the truncated bust of Tsar Nicholas II facing left encircled by an inscription meaning: "By the Grace of God Nicholas II Emperor and Autocrat of All Russias". The reverse of the Medal has an inscription signifying: "For Life Saving".
DIAMETER: 30 mm
RIBBON: Modern Suspension with correct St. Vladimir ribbon