I love turning these sketches into a "card on a card" - this one has the white diagonal piece folded at the top and held down with the chipboard photo corner. Under the flap it says Happy Birthday.
The butterfly stamp is from CTMH - little flowers are from Springtime Stems. I attached the ribbon to spiral clips then adhered to the back of card. Since this is just basically a card front, I adhered a piece of sage shadow to the back to hide the ribbon & spirals.