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Front side - Our Lady of the Immaculate Conception

The face of the medal bears the image of Our Lady of the Immaculate ConceptionShe stands on the world, crushing the head of the serpent. This refers to the passage in Genesis where God said to the serpent, "I will put enmity between you and the woman, and between your offspring and hers; They will strike at your head, while you strike at their heel" (3:15). Mary is seen as a strong force against the powers of evil on account of her "yes" when asked to bear the Son of God.
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Heavenly rays

Heavenly rays extend from her hands, emphasizing how many heavenly graces are granted to those who ask her intercession.
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Front prayer

She is surrounded by the words, "O Mary conceived without sin, pray for us who have recourse to Thee," a prayer the Blessed Mother asked to be put on the medal and to be prayed frequently. It is a simple prayer to ask for her intercession.
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Reverse side - Monogram

The center of the reverse side features a cross with the letter "M." It highlights the union of Mary and Jesus and how true devotion to Mary leads us back to Jesus.
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Twelve Stars

Twelve stars surround the monogram, symbolizing the twelve apostles (the Church in general), and are a reference to a passage from the book of Revelation, "A great sign appeared in the sky, a woman clothed with the sun, with the moon under her feet, and on her head a crown of twelve stars" (12:1).
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Two Hearts

Underneath the cross are two hearts, the Sacred Heart of Jesus and the Immaculate Heart of Mary. This highlights the love both Jesus and Mary have for the world.
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