Appointments of Serving Brothers and Sisters are made about four times a year, with four investitures held annually, when recipients are presented with their insignia.
Through the history of the decoration, small alterations have taken place and help to place any given piece in a rough timescale.
1st Type/2nd Type (1892-1939) - a circular badge with white enamel cross and silver animals raised above the surface of the black enamel medal in a silver rim (two types of suspender) (type 1 & 2).
3rd Type (1939-1949) - circular skeletal badge with ring suspension and the cross set in a silver rim, no black background .
4th Type (1949-1974) - the first badge resumed, but with different ring suspender.
5th Type (1974-1984) - a badge of the same design but with the cross and animals flush with their background.
6th Type (1984-1991) - the cross and animals in white metal alone with no background or rim, slightly smaller than the Officer (Brother) cross and the whole convex on the obverse.
7th Type (1991 - current) - cross and animals thicker, with each arm raised and shaped on both sides of a central channel, the whole in rhodium.
Since 1999, a Woman Officer or Serving Sister in uniform is invested with her breast badge on a straight ribbon.
