1girl, solo, smile, long hair, black hair, crazy eyes, crazy smile, looking at viewer, blood, red eyes, teeth, school uniform, upper body, serafuku, grin, gloves, holding scalpel, open mouth, pink eyes, blood on face, profile, eerie, mysterious, fog, SmoothNoob_Quality

loli, underage, light particles, jpeg artifacts, blurry, SmoothNoob_Negative, SmoothNegative_Hands,