This is Mugetsu's theme from Touhou 4: Lotus Land Story
Is she a milkmaid or something? And what the firetruck is icemilk? Ice cream? Ah well, she doesn't look as innocent as she sounds...
NOTE: I apologize for Gengetsu's legs in the background, I couldn't edit them out :'(
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Mugetsu is the first of two Extra Stage bosses in the Touhou Project game Lotus Land Story...