民国北洋政府直鲁豫巡阅使曹锟六十寿辰纪念章

On the perimeter 直鲁豫巡阅使曹锟敬贈 - Presented by Cao Kun https://en.wikipedia.org/wiki/Cao_Kun, the visiting envoy of Zhili Allied Forces (i.e. Zhili clique https://en.wikipedia.org/wiki/Zhili_clique) in the center of the medallion 六十寿辰紀念章 - 60th Birthday Commemorative Medal