The image shows a person filling out a form with handwritten text. The form appears to be a document, possibly a report or a questionnaire, with multiple lines of text and some numerical entries. The person is using a pen to write on the form, and the handwriting is legible. The background of the image is blurred, focusing attention on the form and the person's hand. The form has a red border at the top, indicating it might be a formal or official document.