Silent Hill Townfall Key Items and Puzzle Solutions

Every lock, safe, and machine that stands in your way in Silent Hill Townfall answers to one of 124 Key Items across all seven maps. Most are story steps you can’t skip, so a stalled puzzle almost always means a code, a setting, or an item you haven’t found yet. The Silent Hill Townfall map of Clara Woods Estate has 32 of them, the longest chain in the game.

Silent Hill Townfall Key Item guide location screenshot


The codes here are the ones Alexandru Popescu entered into each keypad and console on PS5 for Map Master, and you can reach every Silent Hill Townfall guide and map from the same page. Ten Key Items only appear in New Game Plus, and they lead to the Dog and Sci-fi endings rather than the story.


Shorefront Key Item Solutions in Silent Hill Townfall: Zoe’s House, the Pharmacy, and the Scales


Zoe’s house comes first, and Simon needs light before power. Combine the Flashlight (No Batteries) from the kitchen with the AA Batteries upstairs, then add credit at the Power Box with the Prepaid Power Card from Peters Newsagent and flip its switch. The complete Shorefront District South map for Silent Hill Townfall puts the Organ Transplant Box on the kitchen table, where 956 opens the left lock and 133 the right.


The Clinic Scales take three items in a fixed order: the Broken Stethoscope from Jess’s bed on the left, the Prescription Dosage Error Note in the middle, and Zoe’s Lanyard on the right. The Pharmacy locker with the note opens with 6539, the poster order Channel 30 reveals among the CRTV Signal locations and channels. The full Shorefront District North map for Silent Hill Townfall covers the apartment building, where the photos print once the kitchen Printer is on.


St. Amelia Medical Centre Key Item Solutions in Silent Hill Townfall: Pumps, X-Rays, and the Intercom


The surgery needs three medicines at three pump rates: Hydroxalene 3mg from the Records Room kit goes in Pump #1 at 7, Dextracyclate 2.5mg from Bay 6 in Pump #2 at 15, and Tensobromide 11mg from the Pharmacy Store room in Pump #3 at 8. Confirm at the Console on the tray, and the detailed St. Amelia Medical Centre map for Silent Hill Townfall shows the Intubation Kit behind the Storage room squeeze-through.


The X-Ray Panel needs different settings for each scan. Align the skull on the X-Ray Computer, then set kV 3, mA 7, and Time 1, and for the chest set kV 7, mA 3, and Time 1.2 before collecting both from the printer. When Zoe takes the Intercom, respond at the monitors closest to 70/40, then 160, then 80, since the readings can vary slightly.


Silent Hill Townfall Blood Bag Puzzle: Every Medical Centre (Different) Key Item


Five named blood bags unlock the Different hospital’s doors. Alan Duncan’s opens the S.W. Door and Lesley Greer’s, from room S12, the D.P. Door, while Sarah Watson (S05), Matthew Clark, and George McEwan (P10) go into the machines by Patient Charts #1, #2, and #3 for the Transfusion Door. Matthew Clark’s bag only reaches room P03 after you press the Elevator Button in D02.


At the Blood Type Door, link T.F., H.M., and S.W. to the centre ring, then press ORDELL, since Simon’s wristband reads A+ and the plaque lists O-, O+, A-, and A+ as compatible. The Ward W Master Key is on the W04 workbench, the Ward P key comes with George McEwan’s bag, and the Silent Hill Townfall Medical Centre (Different) zone map puts Valves #1 and #2 in D05 and D10.


Clara Woods Estate Key Item Codes in Silent Hill Townfall: Lockers, Safes, and Tapes


Start at the CEG Employee Lockers Computer, which gives 772 for the Lost and Found locker and the South Brae House Key inside. In 5 South Brae, the nightstand Disk Case Key opens both disk cases, and the three black safes give up their Barcodes with 956, 736, and 129, each from a note among the Clue locations for every code.


Scan each Barcode for its locker: 184 for Locker 75, 575 for Locker 17, 971 for Locker 204, and 490 for Locker 94, with Locker 17 also giving the Boltcutters for four iron gates. Combine the three Mechanical Parts by joining the two discs first and the cylinder last, and remember the Upper Brae safe only opens once Tape: Today returns the house to the present.


Richard’s Key Items in Silent Hill Townfall: The Generator and the CEG HQ Projector


Richard’s stretch of Clara Woods starts at the yellow Security Booth Button. Next, set the Facilities Parking Generator’s rear levers so the left and middle are vertical and the right one diagonal, insert the Generator Key from the Manager’s Office, and pull the red lever. The Visitors Building Computer then works and gives you the “DONTREAD.DOC” Clue.


CEG HQ’s fifth-floor Projector needs the Bulb from the Media Department Storeroom and the Lens from the C.F.O. room drawer. Switch it on to free the CEG Maintenance Key, then load the Projector Slides from The Gallery in the order D, F, B, C, E, A for the CEO Access Card. The Silent Hill Townfall CEG HQ zone map also shows Security Room Computer #2, which prints an access card from ID 00007820518 once its printer is on.


SWDP (Different) Key Item Solutions in Silent Hill Townfall: Consoles, Valves, and Pipes


The first console takes the Controller Key, then A5D7 and E3E3 from the Reference Sheet. Turn the red handwheel valves left twice, once, twice, and twice on floors one to four, then press Gas Flow, Flow Test, and IGNITE. The Generator in room B34 powers the main-floor elevator, so switch it on before you need the lift.


The Remote Systems Control console runs the rest: VALVE 254 and FILTER 103 print the 0825 code for the AUX Key locker, then AUX LINE 246 and REGULATOR 592 follow the pipe puzzle, and 047, 621, and 793 open three loot rooms. The Silent Hill Townfall map of SWDP (Different) and the doors each Key Item unlocks show where every code leads.


Silent Hill Townfall New Game Plus Key Items for the Dog and Sci-fi Endings


The Dog ending needs three coins and three Guide Dogs Donation Boxes, all in New Game Plus. The Bronze Coin from the Video Star back room goes in the Main Street box, the Silver Coin from a Clara Woods courtyard shed in the Laundrette box, and the Gold Coin from SWDP room 793 in the box past the final Valve. The Dog and Sci-fi ending trophies list the rest.


The Sci-fi ending needs three Strange Books and the Strange Access Card. Examine the books in Zoe’s bedroom, the Stenhouse after Richard’s call, and SWDP room 621, then take the card from behind the hotel’s Sci-Fi Door and use it on the Sci-Fi Panel before Simon pulls out his IV. The door’s buttons follow the Strange Postcard locations, so collect those on your first run.

Name Details
Infusion Pump #1St. Amelia Medical Centre

Found by the operating table in the surgery room, on the middle left side. After obtaining the medicine (Hydroxaline 3mg, Dextracyclate 2.5mg, and Tensobromide 11mg) scattered throughout the Medical Centre, interact with Infusion Pump #1, select Hydroxaline 3mg, press the "SET RATE" button, press 7, and press the "READY PUMP" button.


After you finish with this Infusion Pump and the other two, don't forget to interact with the Console on the tray by the wall, on the left side of the operating table in the surgery room.


Note: You get tips for this from the Medical Computer (Medication Dosage Table) and the Surgery Whiteboard in the surgery room.

Infusion Pump #2St. Amelia Medical Centre

Found by the operating table in the surgery room, on the bottom left side. After obtaining the medicine (Hydroxaline 3mg, Dextracyclate 2.5mg, and Tensobromide 11mg) scattered throughout the Medical Centre, interact with Infusion Pump #2, select Dextracyclate 2.5mg, press the "SET RATE" button, press 15, and press the "READY PUMP" button.


After you finish with this Infusion Pump and the other two, don't forget to interact with the Console on the tray by the wall, on the left side of the operating table in the surgery room.


Note: You get tips for this from the Medical Computer (Medication Dosage Table) and the Surgery Whiteboard in the surgery room.

Infusion Pump #3St. Amelia Medical Centre

Found by the operating table in the surgery room, on the top right side. After obtaining the medicine (Hydroxaline 3mg, Dextracyclate 2.5mg, and Tensobromide 11mg) scattered throughout the Medical Centre, interact with Infusion Pump #3, select Tensobromide 11mg, press the "SET RATE" button, press 8, and press the "READY PUMP" button.


After you finish with this Infusion Pump and the other two, don't forget to interact with the Console on the tray by the wall, on the left side of the operating table in the surgery room.


Note: You get tips for this from the Medical Computer (Medication Dosage Table) and the Surgery Whiteboard in the surgery room.

ConsoleSt. Amelia Medical Centre

Found on a tray by the wall, on the left side of the operating table in the surgery room. After obtaining the medicine (Hydroxaline 3mg, Dextracyclate 2.5mg, and Tensobromide 11mg) scattered throughout the Medical Centre, interact with the three Infusion Pumps by the operating table and add the medicine. Then interact with the Console to progress the story.


Note: You get tips for this whole process from the Medical Computer (Medication Dosage Table) and the Surgery Whiteboard in the surgery room.

Medical Intubation KitSt. Amelia Medical Centre

The Medical Intubation Kit is found on a shelf behind the Squeeze Through Spot in the Storage room. It is required for story progression.

PatientSt. Amelia Medical Centre

The Patient is found on the operating table in the surgery room. You must intubate him after obtaining the Medical Intubation Kit.


After interacting with the patient, move your PS5 controller until the red circle is shaking, then hold R2. You have to do this three times.

Patient Chart #1Medical Centre - Different

Found on the wall in the middle room of the Medical Centre - Different. Place the Sarah Watson Blood Bag in the transfusion machine next to Patient Chart #1 to open the Transfusion Door at the back of the room.

Patient Chart #2Medical Centre - Different

Found on the wall in the middle room of the Medical Centre - Different. Place the Matthew Clark Blood Bag in the transfusion machine next to Patient Chart #2 to open the Transfusion Door at the back of the room.

Patient Chart #4Medical Centre - Different

Found on the wall by the S.W. Door.

Patient Chart #5Medical Centre - Different

Found on the wall by the D.P. Door.

Hydroxaline 3mgSt. Amelia Medical Centre

The Hydroxaline 3mg is found inside the green first aid kit in the cabinet in the Records Room. Pick it up for story progression.

Room 204 KeyShorefront District South

The key is found inside the bathroom of the hotel room, which Simon explores during his first visit to A Different Place. To collect it, you have to open the Bathroom Door by solving a small puzzle. Once you obtain it, use the key to exit Room 204.

Alan Duncan Blood BagMedical Centre - Different

Alan Duncan Blood Bag is found on the infusion stand by the bed. Use the Blood Bag to open the S.W. Door by placing it in the transfusion machine next to it.

Sarah Watson Blood BagMedical Centre - Different

Sarah Watson Blood Bag is found on the infusion stand by the bed in the middle of room S05 on the S level. The Blood Bag is required to open the Transfusion Door.

Ward W Master KeyMedical Centre - Different

The Ward W Master Key is found on the workbench in room W04. You can use the key to open the locked doors on level W.

Lesley Greer Blood BagMedical Centre - Different

Lesley Greer Blood Bag is found on the infusion stand by the bed in the middle of room S12 on the S level. Use the Blood Bag to open the D.P. Door by placing it in the transfusion machine next to it.

Elevator ButtonMedical Centre - Different

The Elevator Button is found in room D02. Press the button to drop the Matthew Clark Blood Bag to room P03 on the P level.

George McEwan Blood BagMedical Centre - Different

George McEwan Blood Bag is found on the infusion stand by the bed in room P10 on the P level. The Blood Bag is required to open the Transfusion Door.

Ward P Master KeyMedical Centre - Different

The Ward P Master Key is obtained automatically after grabbing the George McEwan Blood Bag in room P10. You can use the key to open the locked doors on level P.

Matthew Clark Blood BagMedical Centre - Different

Matthew Clark Blood Bag is found in the elevator in room P03 on the P level, after pressing the Elevator Button in room D02 on the D level. The Blood Bag is required to open the Transfusion Door.

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