The image is a photograph of a letter from the Galenus Centre de Salut, a medical clinic in Spain. The letter is written in black ink on a white sheet of paper with a blue border. The top of the letter has the logo of the clinic, which is a red cross with the word "Galenus" written in white. Below the logo, there is a note that reads "Thank you for your support and support" in Spanish. 

The note also mentions that the clinic is located in the center of the image and that the patient's name, Dr. David Codina Gráfico, is the recipient of the card. The card has a blue and white logo of General de Catalunya, a company that provides medical care services to the patient.

At the bottom of the note, there are two lines of text, one in Spanish and one in English. The text on the note is signed by the patient and includes their name, address, phone number, and email address.