It says FURUBA (Fruits Basket), Episode 18, Cut 
38.  And on the left, BG (1) Darkish space.  And 
"Tears" on the character's eyes.

The rest just says Studio Deen and copy BG.
Since this is rough layout sketch, the actual 
anime may not have this exact same frame.  So to 
find the screencap, you might want to look for 
the shot that's similar to this and the 
description given.  I'm sorry I haven't watched 
FB for a long time so I don't quite recall... but 
could it be child Yuki-kun crying? ^_^

Hope this helps!
isl ^_^