WITH CTE AS(SELECT *, N=ROW_NUMBER()OVER(PARTITION BY Регион ORDER BY Оценка))
SELECT Регион, Человек, Оценка
FROM CTE
WHERE N<3
ORDER BY Регион, Человек, Оценка;

WITH CTE AS(SELECT *, N=ROW_NUMBER()OVER(PARTITION BY Регион ORDER BY Оценка))
SELECT Регион, Человек, Оценка
FROM CTE
WHERE N<3
ORDER BY Регион, Человек, Оценка;

WITH CTE AS(SELECT *, N=ROW_NUMBER()OVER(PARTITION BY Регион ORDER BY Оценка) FROM Таблица)
SELECT Регион, Человек, Оценка
FROM CTE
WHERE N<3
ORDER BY Регион, Человек, Оценка;

IF EXISTS (SELECT 1 FROM sysobjects WHERE name=N'Tabel' and type='U') DROP TABLE Tabel
CREATE TABLE Tabel (
  [Человек] nvarchar(50),
  [Регион] nvarchar(30),
  [Оценка] int
)
GO
DECLARE
  @I int = 10000
BEGIN TRAN
WHILE @I>0 BEGIN
  INSERT Tabel ([Человек], [Регион], [Оценка])
    VALUES (N'Name'+CONVERT(nvarchar(11),@I)+N' Middlename'+CONVERT(nvarchar(11),@I)+
	  N' Lastname'+CONVERT(nvarchar(11),@I),
	  N'Name'+CONVERT(nvarchar(11),CONVERT(int,RAND()/0.1*10)), CONVERT(int,RAND()/0.1*10)
	)
  SELECT @I=@I-1
END
COMMIT TRAN
GO

select top 2 with ties t.*
from Tabel t with(nolock)
orderby(row_number()over(partition byt."Регион" orderbyt."Оценка" asc)-1)/2 --, 1, 2, 3

SELECT [Регион], [Человек], [Оценка]
FROM (SELECT *, ROW_NUMBER() OVER(PARTITION BY [Регион] ORDER BY [Оценка]) AS N FROM Tabel) Q
WHERE N<3
ORDER BY [Регион], [Человек], [Оценка]