Some relevant pics from the net. Now as for a double award nowadays which is extremely unlikely to ever happen "Department of Defense MANUAL NUMBER 1348.33, Volume 1 November 23, 2010 Incorporating Change 1, October 12, 2011 h. Subsequent Awards. In accordance with sections 6247, 3744, and 8744 of Reference (k), no more than one MOH may be awarded to an individual. However, for each succeeding act that would otherwise justify award of the MOH, the individual receiving the subsequent award is authorized to wear an additional MOH ribbon and/or a “V” device on the MOH suspension ribbon. i. Duplicate Awards. In accordance with sections 3754, 6256, and 8754 of Reference (k), a person awarded the MOH shall, upon written application of that person, be issued, without charge, a duplicate MOH with ribbons and appurtenances for display purposes. Note that the MOH flag is an appurtenance of the MOH. Therefore, MOH recipients are authorized, upon written application, a duplicate MOH flag for display purposes. j. Authorized Devices. “V” Device. A “V” device is worn centered on the suspension ribbon to denote each subsequent award."