score_9, score_8_up, score_7_up, source_anime, aakana, long hair, twintails, ahoge, hat, nurse cap, x hair ornament, mole under eye, eyes visible through hair, blush, fangs, large breasts, nurse, white dress, short sleeves, bandaged arm, wrist cuffs, white gloves, white apron, blurred dreamy colorful purple atmosphere, wide smile ,big eyes small pupils, zoomed into face, insane expression, heart eyes, bright pink background, yandere, stressed, mentally ill , holding a gun, crying blood