Silent Hill Townfall Clinic Scales Puzzle Solution (All Item Locations)

The three scales tucked into the back room of the Shorefront Family Clinic look like a weighing puzzle, and they are not. Nothing gets balanced, nothing gets measured, and there is no timer. Each plate accepts exactly one key item, and the Resignation Letter sitting in the same room tells you which item goes where.

Quick answer: Use the left scale for the Broken Stethoscope, put the Prescription Dosage Error Note on the middle scale, and reserve the right scale for Zoe’s Lanyard. The cutscene begins as soon as the final object is placed properly.

Where the scales are in the Shorefront Family Clinic

The Shorefront Family Clinic sits in Shorefront District — South, just off the town square. Follow the corridor inside to the room marked Z. Ellis at the end, a storeroom stacked with cardboard boxes. The three scales sit on those boxes under the window. You can interact with them right away, but nothing happens until all three items are in your Key Items.

Map Location: Pharmacy — The Shorefront District — South map, showing both the Scales inside the Clinic and the Pharmacy. Shown at 00:12 in Ghosts of Reykjavik’s video. Image: Screen Burn

Scales puzzle solution: which item goes on which scale

Scale	Item	Resignation Letter line
Left	Broken Stethoscope	“I didn’t listen closely enough”
Middle	Prescription Dosage Error Note	“I made mistakes and couldn’t focus”
Right	Zoe’s Lanyard	“I’m not fit for this role any longer”

Read those three lines literally and the mapping falls out. A stethoscope is what a nurse listens through. The dosage note is the recorded mistake, addressed to Nurse Zoe Ellis about Mr. Stewart’s prescription. The lanyard is an access ID that lists her role as District Nurse. Weight is irrelevant, and the order you place them in does not matter either — the puzzle resolves as soon as all three plates hold the right object.

Grab the Scalpel in the Z Ellis room before you leave

Of the three items, two are located beyond rusty doors that have a central hatch, and the same tool handles every one. In the Z Ellis room with the scales, remove the Scalpel from the green medical case sitting on the desk beside the computer. Also collect the Resignation Letter from the box for the three lines above, then power up the computer and read Zoe’s email; it gives Jessica White’s address as 21 Farrow Street.

Without the Scalpel, both the Pharmacy door and the south gate into St. Amelia Park stay shut, which puts two of the three scale items out of reach.

Zoe’s Lanyard location: the organ transport box in Zoe’s House

You almost certainly have this one already, since the lanyard is what unlocks the clinic door in the first place. If you somehow skipped ahead, here is the whole chain.

From the town square, enter Zoe’s House on its west side and search the kitchen. The Flashlight Without Batteries is in the drawer to the cooler’s left, identified by the words “HUMAN ORGAN IN TRANSIT”.

Step 1 map location — Zoe's House, marked on the Shorefront map west of the town square. Shown at 00:03 in 100% Guides’s video. Image: Screen Burn

Head upstairs, take the second doorway on the left, and open the small cabinet drawer for the AA Batteries. In your inventory, combine them with the flashlight.

Visit Peters Newsagents and remove the Prepaid Power Card from the register. Before leaving, take the wooden board near the exit so you have a weapon.

Return to Zoe’s House and crouch into the opening next to the stairs, where the meter panel is located. Put in the Prepaid Power Card, use Button A repeatedly until the screen shows Card Credit, press Button B, and finish by toggling the main switch at the lower right.

With power restored, turn on the upstairs computer, refresh the inbox and open the middle email. Then collect the Organ Transplant Card from the floor of the upstairs bathroom.

Examine the cooler in the kitchen and enter the code on its left three-digit dial, followed by the right-hand dial. Select Yes to unlock it; following a brief cutscene, Zoe’s Lanyard appears in your Key Items.

Entering Left Lock Code — Dialling the left three-digit tumbler on the organ transport box. Shown at 00:25 in Quick Guides’s video. Image: Screen Burn

Zoe’s email and the Organ Transplant Card determine both dial codes, meaning your displayed numbers may differ from another player’s. This cooler has produced pairs including 956 / 133, 067 / 234, and 067 / 244; derive yours from the clues in your game.

Prescription Dosage Error Note location and the Pharmacy locker code

Find the Pharmacy south of St. Amelia Park near the town square. At the entrance, interact with the rusted hatch panel and choose the Scalpel to slice the door open.

Step 2 Map Location — The Pharmacy, highlighted on Main Street. Shown at 00:40 in Quick Guides’s video. Image: Screen Burn

Use the flashing set on the reception desk to tune the CRTV. Steady the picture and line up the colours, and the broadcast points at four posters hanging around the shop.

In the back room, pass the counter and set the four-dial padlock on the rusty locker to 6539. After opening it, remove the Prescription Dosage Error Note from the paper medical bag inside.

Locker Code Combination — The Pharmacy locker dialled to 6-5-3-9. Shown at 00:32 in Ghosts of Reykjavik’s video. Image: Screen Burn

Read the posters in the sequence shown by the CRTV clip to get those digits: the hand-washing poster has six fingers, the prescription drugs poster shows 5, the nurse consultation poster places 3 on the scale, and the antibiotics pack contains nine pills. Should 6539 fail, use the posters in your own game; 7649, 7592, and 7654 are among the other combinations reported for this lock.

Broken Stethoscope location: Jess’s House on Farrow Street

At St. Amelia Park’s southern entrance, cut open the hatch door with the Scalpel. The passage afterward crosses the park and leads in the direction of Farrow Street.

At the playground, go left and enter the alley. Slip through the gap in the final garden, which brings you onto Farrow Street. Jess’s front-door note identifies number 16 as the key’s location.

Building 16 is across from Building 14. Enter it, go upstairs to flat 1/2, and collect the 21 Farrow St. – Back Door Key from the living-room table.

Go back down to street level and take the alley beside Building 14 to the blue back door of Jess’s House. Unlock it, climb to the bedroom, and lift the Broken Stethoscope out of the open medical bag on the bed. Its tubing has been cut on purpose, which is the point.

Placing the items and confirming the puzzle is solved

After collecting all three objects as Key Items, return to the clinic and follow the corridor to the Z Ellis room. Examine the scales one by one: the left receives the stethoscope, the centre takes the dosage note, and the right takes the lanyard. No confirmation input is required.

Solving the scales puzzle — Placing the Broken Stethoscope on the left scale in the Z Ellis room. Shown at 01:18 in Gamerack’s video. Image: Screen Burn

The game confirms the solution immediately: placing the last object correctly triggers a cutscene without further input. Zoe’s video tape plays, the Resignation trophy unlocks, and Part 2: Zoe begins.

If all three are down and nothing happens, swap the stethoscope and the dosage note first. Those two are the pair players mix up most often.

After the cutscene, you have finished everything required in that room. None of the three objects is useful again, so revisiting the scales serves no purpose.