Dąbrowski has an unidentified “Masonic Symbols”, see below. The image itself says: “Templar Chart” so I suppose these are symbols from Templar degrees.
In the left part of the bottom you see what appears to be a branch of something and a mirror. The mirror has second “craft” degree significance in some rites, but I suppose this combination has some Templar significance.
Also see “mirror“.
Dąbrowski P. 168. Year and designer unknown. A very similar (but not identical) image can be found on http://www.freemasons-freemasonry.com/TBs.html (accessed 24/7/24). This is a certificate with description: “Phoenix Temple of Honor, 1870”.