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Tibetan printed prayer roll. The first three lines are repetitions of Om Mani Pad Me Hum - the six syllable mantra symbolizing the power and blessings of Avaloketisvara, the God of compassion. The fourth line is a repetition of the 100-syllable mantra for protection against all kinds of harm.
This roll, which has been printed with mantras was probably placed inside a hand-held prayer wheel. In Tibetan Buddhism prayer wheels are spun in order to activate the mantras they contain. Whilst spinning the wheel the devotee maintains a focused mindset and may also recite mantras in order to fully realise the merit gained from the spinning the wheel.