The Zen beaded medical bracelet is a meaningful design of enlightenment, peace and calm It is a combination of sterling silver and gold plated beads with your choice of either a Buddha or Equality charm. Allow our Zen bracelet to help you in being present, aware and mindful of nothing but positive thoughts. All N-Style ID beaded medical bracelets should be removed before showering or water activities and are not recommended for everyday wear. For everyday wear, we recommend switching the beaded bracelet to the discounted stainless steel chain bracelet or one of our other stainless steel chain bracelets Charms pictured are sold separately and will come attached to the ID tag.