Tiny plastic half domes were glued onto the mailer before painting with black gesso to look like rivets and the resin hand is a cabochon molded (I only molded the hand and not the oval behind it).
Clipart is from internet search engines and for the numbers and words below the slide pictures I used Martha Stewart's Custom Stamp Setting Kit - the two headed skellie is ( like the hand above), resin poured into a cabochon mold.
The back is a tag holder made from clipart with a smaller version printed and used on a small punched tag, the skull is resin from a mold that I made from a Halloween necklace.
Inside, I wasn't too happy with the worded side .. I just couldn't find much fantastic INSANE clipart but I'm basically happy with how it turned out.
Thanks for looking.