There are markings in blue ballpoint pen. There is one fold. Please check the photos. This is not a new item, so it is not in perfect condition. Thank you for your understanding. Immediate purchase and midnight purchases are welcome. We also accept requests for combined purchases. Please feel free to ask! Shipping is anonymous, waterproof, and carefully packaged. "Mental Health Management Certification Exam Official Textbook 3 Types Self-Care Course, 5th Edition" Osaka Chamber of Commerce and Industry Price: ¥2000 "Mental Health Management® Certification Exam Official Textbook III Self-Care Course (5th Edition)" is an official textbook aimed at general employees, designed to equip them with the knowledge and skills to promote mental health measures in the workplace themselves.