3x+9(x+2)(x-2)/4y(x+3)(x+3)

(3x + 9) (x + 2)(x -2)/4x(x + 3)(x+3),

3(x + 3)(x + 2)(x - 2)/4x(x + 3)(x+3),
Cancel a pair of (x+3) factors:
3(x + 2)(x - 2) / 4x(x + 3).