Our N-Style ID Autumn medical ID bracelet is an adjustable bracelet with an earthy casual style. The tiny seed beads are woven in a simple Aztec pattern of copper, white and granite which are all wrapped up in leather cord to make an Indian style bracelet. The size is adjustable by where you choose to place the button in the knotted leather. Size adjusts from a 6" wrist up to an 8" wrist. 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 offered below or one of our other stainless steel chain bracelets Charms pictured are sold separately and will come attached to the ID tag.