It's right-to-left, definitely. The shout in the first panel is clearly supposed to be occurring at the moment she bursts out of the floor.
So from now on I'm gonna start calling you Cirno.GIVE ME YOUR LIFE!!Oh, that hurt like hell.
I might die.Oh, it's Tsirnow.Huh?
Tsi... what?Look, I've been thinking.Reimu, is there something wrong with your head?Tsirnow is really hard to pronounce, you know.Uh? Uh?
It's always been Cirno.
What are you talking about?
Ah... Consciousness starting to get hazy.