There are medals (as is commonly seen with a bar, ribbon and coin descending from the bar). There are miniature medals (worn on formal occasions). Some medals have ribbons (small bar with the ribbon around it). Not all ribbons have medals. Good conduct ribbons in all services also have medals. Rifle and Pistol qualifications (unless expert) do not have medals.

I know its confusing to civilians but you can toss ribbons without tossing medals.

I've been in for nearly sixteen years. I have my records allthe way back to the beginning of my service. Some in triplicate and/or more.
To have absolutely nothing to prove that he served out a year in one place with nothing to show but one pay stub is absolutely astounding to me. Every year I have about a pound or more of paperwork generated just because I exist much less because I create it.