Guide
Silent Hill: Townfall Hospital Puzzles: Every Answer
On this page
Patient vitals (surgery intercom)
Each mistake that damages Zoe's health during the surgery puzzles costs −3 from the hidden ending score, and Justice needs 20 or more — see the endings page for the full math.
| Field | Value |
|---|---|
| Blood pressure | Systolic 70, diastolic 40 |
| Pulse | 160 |
| SpO2 % | 80 |
X-rays: skull and chest
Align each film first — the reader must show "Patient Skull – Aligned" / "Patient Chest – Aligned" — then power ON, set the values and expose.
| Film | Site | kV | mA | Time |
|---|---|---|---|---|
| Skull | Skull | 3 | 7 | 1 |
| Chest | Chest | 7 | 3 | 1.2 |
Infusion pumps (88 kg patient)
Hydroxalene comes from the Records room (code 2605), so open that before setting the pumps. A wrong rate that hurts Zoe counts as a surgery mistake (−3 each).
- On each pump: SET RATE, enter the number, confirm with the check mark, then READY PUMP.
| Drug | Rate |
|---|---|
| Dextracyclate | 15 |
| Hydroxalene (from Records room 2605) | 7 |
| Tensobromide | 8 |
Intubation
| Step | Setting |
|---|---|
| Input | Hold R2 / RT on each flashing red spot |
| Order | Right side, then lower left, then top |
Blood bag wall (Otherworld transfusion area)
| Spot | Bag |
|---|---|
| Transfusion machines | Alan Duncan bag on S.W., Lesley Greer bag on D.P. |
| Left spot 1 | Sarah Watson |
| Left spot 2 | Matthew Clark |
| Right spot | George McEwan, then the switch left of the double doors |
Ordell blood circle
| Step | Setting |
|---|---|
| Goal | Only O−, O+, A− and A+ reach the centre — Simon Ordell's type, from the Medical Wristband |
| Rings | Rotate until T.F., H.M. and S.W. line up in straight lines |
| Confirm | Press ORDELL |
Hospital codes
The Records room holds Hydroxalene, one of the three infusion drugs, so open it before setting the pumps. All Part 3 locks, with clues, are on the all-codes page.
| Lock | Where | Enter | Unlocks |
|---|---|---|---|
| Locked door — Surgery | St. Amelia Medical Center | 7103 | Opens the surgery-side door |
| Records room door | Chapman Ward, ground floor | 2605 | Hydroxalene (infusion pump drug) |
| Hospital Storage phone | Reception phone | Dial 5353 | Hospital Storage line |
How do surgery mistakes affect the ending?
Each mistake that damages Zoe's health during the surgery puzzles subtracts 3 from the hidden ending score; Justice needs 20 or more. Kills and revives as Zoe do not count — only her surgery mistakes. The full factor table is on the endings page.
Two trophies sit in this chapter: The Patient for finishing every Medical Centre puzzle as Zoe, and Save It For The Patients for using no healing items in her chapters Rounds and The Patient. Both are tracked on the trophy list.
Sources & verification
- PowerPyx — Silent Hill Townfall speedrun walkthrough and all puzzle solutions, all 34 puzzles in story order (September 21, 2026)Media coverage · 2026-10-15
- PowerPyx — Silent Hill Townfall all endings guide: score weights, the 85 Clues and Documents, Dog and Sci-fi stepsMedia coverage · 2026-10-15
- KeenGamer — Silent Hill: Townfall all puzzle solutions (Ali Amir, September 23, 2026)Media coverage · 2026-10-11
- KeenGamer — Silent Hill: Townfall trophy list and achievements guide (Rafly Wibowo, September 25, 2026)Media coverage · 2026-10-11