1.     For distinguished service of the most exceptional order.  

2.     All ranks of the Armed Forces including Territorial Army Units, Auxiliary and Reserve Forces (when embodied) and other lawfully constituted Armed Forces.  

3.     Nursing officers and other members of the Nursing Services in the Armed Forces.  

4.     If a recipient of the medal is subsequently awarded the medal again, every such further award shall be recognized by a Bar to be attached to the riband by which the medal is suspended. For every such bar, a miniature insignia of a pattern approved by the Government shall be added to the riband when worn alone.