I think the idea is that you paste pictures in the bigger boxes, and type words in the smaller boxes underneath.

There are enough boxes in that document for 20 pictures and words. So perhaps you could set a topic like

"Clothing". That Title is a picture so you can either replace it with a picture saying Clothing or just use text for the heading, and then fill in the boxes with a picture of a shirt with the word "shirt" underneath, and then 19 other items of clothing.

https://www.eslkidsgames.com/pictionary has instructions of how to play pictionary in an ESL class but of course you can change it as you like to try and make sure it suits your students and your lesson. You could either tell each team which word they need to draw, or let them choose for themselves. Perhaps it would be best to give each team a different worksheet too; otherwise it will be too easy to guess and the team/s that they are playing will just go through the list of words on their sheet.

 

I hope that helps!  

1) To write a word, insert the cursor in the box and start typing.

2) To insert a picture, select the box, go to Drawing Tools and follow the steps in my screenshot:

 

 

 

I hope it helps. 

 Would it be helpful if I provided some sample Pictionary topics or categories that could work well for an ESL classroom?