Title: (Reitaisai 10) [Gainamon (Natsu no Koucha)] Toraware Yousei (Touhou Project)
JPN Title: (例大祭10) [がいなもん (夏の紅茶)] 囚ワレ妖精 (東方Project)
Commissioner wished to remain anonymous for this one, thought I should put it up as alternative scan.
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You can view it here