You are looking at a Medal for Life Saving by Tsar Alexander III. The Medal was first instituted on April 17, 1828. After the death of Tsar Alexander II, the Medal was reissued ,after 1881 for the new Sovereign, Tsar Alexander III. The medals were bestowed upon individuals for deeds involving for saving lives.
The obverse shows the truncated bust of Tsar Alexander III facing right encircled by an inscription meaing: "By the Grace of God Alexander III Emperor and Autocrat of All Russias". The reverse of the Medal has in inscription signifying: "For Life Saving".
DIAMETER: 29 mm
RIBBON: Modern Suspension with St. Vladimir ribbon