This is a hand drawn card, or rather the original was. I took two pictures, one of the black and white outlines, and another of the finished, hand coloured one, but the second one didn't come out that well, so I used the outlines, traced them and converted them to paths and then coloured them in using Photoshop and added some texture and colour adjustments. Most of the fill patterns are mine, but there are a couple from Pixels & Ice Cream.
All other images/textures/brushes my own. Edited in Photoshop.