At private facilities like Arkham Sanitarium patients suffering from mild disorders were frequently allowed to leave the confines of their treatment ward and roam the grounds relatively unsupervised. Watchful eyes would still be upon them, but walks and general lounging in the outdoors were viewed as useful exercises that physically and mentally refreshed residents. The freedom of a ward pass would never be bestowed on anyone violent unless, of course, they were consciously concealing their capacity for mayhem.
This pass is sized to fit on a standard 3" by 5" index card, preferably colored cardstock. The easiest way to print it is to adjust your printer's custom document sizing to 3x5, print one side, and then flip the card and send it through a second time to print the opposite side.
I tried a slightly different technique for reproducing the look of vintage printing on this and would appreciate any feedback.