To make a birthday card for a Pisces, you should focus on their imaginative, sensitive, and spiritual nature. Here are some ideas on how to create a special and meaningful card:

1. Use dreamy and soft colors. Blue and purple are excellent choices since they symbolize the ocean and the mystical. Sprinkle some glitter or sparkles to make the design look magical.

2. Add a meaningful quote or poem. Pisces are fond of wisdom and inspiration that touches the soul. You can include a verse from their favorite poet or philosopher or write your own that encapsulates how you feel about them.

3. Draw or print mystical elements such as unicorns, mermaids, fairies, or any magical creature that they love. You can also include a picture of the Pisces constellation or a fish to remind them of their Zodiac sign.

4. Use beautiful handwriting or calligraphy for the message inside the card. Pisces appreciate beauty in all its forms, and they would notice the effort you put into making the card more elegant and expressive.

5. Write a heartfelt message. Take the time to express your gratitude, admiration, and love for the Pisces person. Acknowledge their unique qualities and how they enrich your life. Remind them of the wonderful adventures and memories that you share and wish them more happy and fulfilling moments to come.

6. Lastly, add some personal touches such as stickers, washi tape, or anything that signifies your friendship or connection. You can add inside jokes or memories that would make the Pisces person smile and feel cherished.

In conclusion, making a birthday card for a Pisces requires creativity, sensitivity, and an appreciation for the mystical and imaginative side of life. By pouring your heart and soul into the card, you are not only celebrating their special day but also showing how much they mean to you.