The way they probably did that blue box would be by cutting a hole in the mask for the cyan plate, making a cyan rectangle. The formerly red area ends up dark blue/purple because of the red overlay. and the rest is greenish where yellow would have been part of the sign.
Where it meets the ear you can see how the cyan has no halftone dot pattern.
Scribbles were probably done on the press by scratching or scuffing the plate.
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