Silent Hill: Townfall Clinic Scales Puzzle and Item Locations

Match the letter to the three objects

The puzzle is in the Z Ellis office at the end of the Shorefront Family Clinic corridor. Zoe’s letter connects three regrets with three objects: failing to listen points to the stethoscope, a medical mistake points to the dosage note, and leaving her professional role points to the lanyard. Read those ideas in the letter’s order and assign them from left to right.

You are choosing symbolic objects, not trying to calculate equal weights. Do not search for a replacement set of weights or assume the damaged stethoscope needs repair before it can be used.

First item: keep Zoe’s Lanyard

The lanyard comes from the organ transport box in Zoe’s house and is also used to enter the clinic. If you have reached the scales through the normal route, this is the item you should already have. It goes on the right platform, even though you collected it before the other two.

Second item: the pharmacy note

Take the Scalpel from the green case near Zoe’s office computer. Use it to enter the pharmacy, solve the back-room locker, and take the Prescription Dosage Error Note. That item belongs on the middle platform. The separate locker guide explains the CRTV poster sequence if you want to check the combination against its clues.

Third item: find Jess’s key and the stethoscope

Use the Scalpel to pass the sealed entrance into St. Amelia Park. Continue toward Farrow Street and locate building 16, opposite building 14. Go upstairs to flat 1/2 and take the 21 Farrow St. – Back Door Key from the living-room table.

Return to Jess’s house and use that key at the back entrance in the alley beside building 14. Search the bedroom bed for the Broken Stethoscope. It belongs on the left scale. The key’s address identifies the door it opens; the pickup is in the neighbouring building, which is why searching only Jess’s locked house does not find it.

Return and place all three items

Bring the objects back to the Z Ellis office, check the left–middle–right arrangement, and place them. VGC and GameRant both report an immediate cutscene when the correct arrangement is completed. Save and finish anything you intend to inspect nearby beforehand. This guide stops at that transition to avoid later story spoilers. The route is corroborated by launch walkthroughs checked September 23, 2026.

Common questions