Hola Mike si porsupuesto lo puedes hacer con Gdi y otras DLL pero tambien con algunas funciones de VB tales como "Print" para los texto y PaintPicture para las imagenes. lo unico que no podrias mediante las funciones de vb es rotar el texto, para eso te paso un ejemplo del api guide utilizando algunas apis
'In general section
Private Declare Function CreateFontIndirect Lib "gdi32" Alias "CreateFontIndirectA" (lpLogFont As LOGFONT) As Long
Private Declare Function SelectObject Lib "gdi32" (ByVal hdc As Long, ByVal hObject As Long) As Long
Private Const LF_FACESIZE = 32
Private Type LOGFONT
lfHeight As Long
lfWidth As Long
lfEscapement As Long
lfOrientation As Long
lfWeight As Long
lfItalic As Byte
lfUnderline As Byte
lfStrikeOut As Byte
lfCharSet As Byte
lfOutPrecision As Byte
lfClipPrecision As Byte
lfQuality As Byte
lfPitchAndFamily As Byte
lfFaceName(LF_FACESIZE) As Byte
End Type
'In form
Private Sub Form_Load()
'KPD-Team 1998
'URL: http://www.allapi.net/
'E-Mail: KPDTeam@Allapi.net
Dim RotateMe As LOGFONT
'Set graphic-mode to 'persistent graphic'
Me.AutoRedraw = True
'Rotate degrees
Deg = 270
'Size (in points)
Size = 20
'Set the rotation degree
RotateMe.lfEscapement = Deg * 10
'Set the height of the font
RotateMe.lfHeight = (Size * -20) / Screen.TwipsPerPixelY
'Create the font
rFont = CreateFontIndirect(RotateMe)
'Select the font n the Form's device context
Curent = SelectObject(Me.hdc, rFont)
'Print some text ...
Me.CurrentX = 500
Me.CurrentY = 200
Me.Print "hola mundo"
End Sub
en fin el no se exactamente todo lo que tienes o quieres que hacer pero mejor anda preguntando cosas especificas, asi vamos por parte.