ShieldSanguine, on a cross Argent a sword point down of the field hilted Or.
CrestOn a wreath of the colors Argent and Sanguine, a fusil Gules charged with the staff of Aesculapius Or.
ShieldThe shield is sanguine, the nearest heraldic color to the Medical maroon, which represents the original service of the organization. The cross is from the arms of the old Lords of Dun and commemorates the passage of the Meuse near Dun, the great achievement of the Fifth Division, when an ambulance from that regiment was the second vehicle across the Dun Bridge, 6 November 1918. The sword shows the military character of the unit, while the point being down indicates that its personnel did no fighting.
CrestThe insignia is the shoulder sleeve insignia of the Fifth Division charged with the ancient emblem of the medical profession.
The coat of arms was originally approved for the 5th Medical Regiment on 6 June 1921. It was redesignated for the 4th Medical Battalion on 12 October 1940. The insignia was redesignated for the 204th Support Battalion with the symbolism revised on 2 June 1987.