The article presents a Northern Thai manuscript titled Withi bucha that thang si (‘How to pay homage to the four physical elements’). The text has been used as a master version in traditional healing rituals. It is analyzed what roles different parts of the text play in these ritual by applying the Four Key Factors (Production, Use, Setting, Pattern) as heuristic tool. The manuscript is textually dominated by a main prayer named okāsa reflecting the twofold communication between the spiritual sphere and the human sphere based on local the local belief system encompassing Buddhism and spirit cults. Three hybrid modes related to the manuscript are identified: hybrid content, hybrid use, and hybrid communication, structurally comprising oral parts for recitation and non-oral parts for silent reading.