Five Russian soldiers have received the "Order of Courage" from President Vladimir Putin, including a colonel and two women sergeants killed by Syrian rebel shelling of Aleppo.
The women were serving as medics at a field hospital in western Aleppo. A mortar struck the hospital on Monday.
A Russian paediatrician seriously wounded in that attack also received the medal.
A fifth Order of Courage went to a Russian colonel wounded elsewhere.
Russia is helping Syrian state forces.
The Kremlin named the five decorated with the Order of Courage for their service in Syria as:
- Col Ruslan Galitsky, a tank specialist advising President Bashar al-Assad's forces, killed by rebel mortar fire in Aleppo
- Sgt Nadezhda Durachenko killed in the field hospital attack
- Sgt Galina Mikhailova killed in the same attack
- Prof Vadim Arsentyev, paediatrician wounded in the same attack
- Col Eduard Skvortsov, wounded in a separate incident
Russia's Tass news agency lists Russia's combat losses so far in the Syria conflict as: 21 military personnel, three helicopters and an Su-24 bomber.
A special forces officer - Senior Lt Alexander Prokhorenko - "died heroically" in March near Palmyra, the Russian government said. He was decorated as a national hero for having called in an air strike against so-called Islamic State (IS) militants, who had surrounded him.
Russia's "anti-terrorism" operation in support of President Bashar al-Assad in Syria began on 30 September 2015.
Russia has mostly carried out intensive air strikes in Syria - including with cruise missiles fired from warships. But Russian special forces and military advisers are also helping Syrian government troops on the ground.
According to a Reuters investigation, Russian private contractors or mercenaries are also fighting in Syria, in support of the official military contingent.
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