QEII is wearing colonel's insignia (crown and two pips) and the thistle on her collar and the buttons in groups of three down the front of the uniform mean she's in her official capacity as Colonel in Chief of the Scots Guards. Her decorations are all from serving as an ambulance driver in London during the war. This photo will have been taken in England, as she's wearing the Star of the Garter. If she were in Scotland she'd be wearing the Star of the Thistle.
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