Catalog
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| Location | United Kingdom |
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| Year | 1970 |
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| Orientation | Medal alignment ↑↑ |
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| Obverse description | Relief portrait bust of footballer Jack Charlton facing slightly right occupies the central field, with his facsimile signature incused below in the exergue. The legend JACK CHARLTON arcs along the upper periphery in raised letters. |
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| Obverse script | Latin |
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| Reverse script | Latin |
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