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Old 01-14-2014, 03:32 PM   #1
Tommy
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For Bravery,0151772,Cook,376th Rifle Division,Volkhov Front

Form nr. 1

(To be filled out using a typewriter, without any corrections)

Date and place of issue of the award (raion, city, oblast, krai, republic):

Record card of an awardee

1. Last name: Galkin
2. First name and patronymic: Andrei Dmitriyevich
3. Nationality:
4. Sex:
5. Year of birth: 1919
6. Place of birth:
7. Education: higher, unfinished higher, special secondary, secondary, elementary (underline what is relevant):
8. Party affiliation:
9. Position, profession, military rank (for servicemen), and place of work or service at the time of the award (ministry, department, institution, enterprise, organization): Rifle company first sergeant in the 1248th Rifle Regiment
10. Home address of the awardee: 44 Gogol Street, city of Balakleya, Kharkov Oblast

11. Awards issued:

Type of award (order, medal, highest title of distinction, or honorary title) Serial number of the order, medal, or badge Number of the order booklet, Hero or Mother Heroine booklet, medal or badge certificate, or travel document Date and number of the award Decree
Medal for Courage 151772 Temporary certificate nr. 315231 Order of the 1248th Rifle Regiment nr. 05/N of January 24, 1945 [sic]


Signature of the awardee:

I confirm the correctness of the data and the signature of the awardee (position and signature):



12. Remarks:

1.jpg

2.jpg
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