The image is a scanned document with various elements on it. At the top, there's printed text which appears to be a form or report title, although it's not entirely clear from this angle. The main area of the document shows a grid filled with small dots or symbols, and some of these are crossed out by hand with a pen, suggesting an indication of 'incorrect' answers. There are also hand-written annotations with arrows pointing to certain areas within the grid, possibly explaining a correction or selection made by the person who filled out the form. The bottom part of the document includes more text and symbols, which could be instructions or information relevant to the main grid. The overall style is informational, likely educational or instructional in nature.