Four way medal in sterling silver made in the USA. The heart shaped medal is designed with St. Christopher, St. Joseph, the Sacred Heart of Jesus, the Miraculous Medal, and a Holy Spirit. The reverse side of the medal portrays the back of the Miraculous and Scapular medals. This medal is die struck, using only the finest grade solid sterling silver material. This enables the fine detail of the coined precious metal to fully show when the antique finish from hand polishing is applied to each medal by New England Silversmiths. It is then highlighted by hand engraving, to display the beautiful sheen of pure sterling. An 18" rhodium plated curb chain is included with a deluxe velour gift box. Dimensions: 13/16" x 3/4"