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О внесении дополнений и изменений в Указ Губернатора Калининградской области от 22 ноября 2010 года N 366 "О реализации требований Уставного закона Калининградской области "О наградах Калининградской области"

Форма документа, подтверждающего награждение медалью "Материнская слава"

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¦            УДОСТОВЕРЕНИЕ             ¦                                      ¦

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¦              к медали                ¦                                      ¦

¦         "Материнская слава"          ¦                                      ¦

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¦           Рисунок медали             ¦              (фамилия)               ¦

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¦                                      ¦                (имя)                 ¦

¦               медаль                 ¦          _________________           ¦

¦         "Материнская слава"          ¦              (отчество)              ¦

¦                                      ¦              награждена              ¦

¦                                      ¦      медалью "Материнская слава"     ¦

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¦     удостоверение N  __________       ¦           награда N ______           ¦

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¦                                      ¦ Губернатор                           ¦

¦                                      ¦ Калининградской области ____________ ¦