Alchemilla Hospital - Silent Hill: Homecoming Guide - IGN (2024)

Solving the Keypad Puzzle

The game begins with a displayed-button sequence. While the orderly who has brought Alex into the hospital is getting murdered outside by the Executioner (a.k.a. the Bogeyman, or Mr. Pyramid Head), mash the button shown on the screen to break off the straps.

This room is the 2F Operation Theater. Walk around a bit and get used to the game's weird controls, and then open the double doors, and go through the next set of double doors to find Joshua behind a gate. This locked gate has a keypad near it.

Open the door next to the keypad gate to the Nurse's Center. Take the Hospital Map on a bulletin board. There is a partial x-ray image on the screen here. Alex will need to find the other half of this image to see the complete numeric code.

Checking with the map as necessary, go to Room 203. Investigate the child-like doll inside the middle incubating chamber to make it shut the hell up. Take the Health Drink on a counter.

The window into Room 204 is already broken, so hop over into Room 204. Take the X-Ray Film on the screen.

With the X-Ray Film obtained, backtrack to the Nurse's Center. Use the X-Ray Film on the other half there to complete the image and to see the entire code: 624872.

Enter the code 624872 on the keypad for the gate outside. Follow Joshua through the 2F Men's Restroom to the Storage Room. There is a Save Point here.

Finding the Combat Knife and the Operation Theater Key

Continue to the 2F Women's Restroom. Take the Combat Knife on the mirror. As soon as Alex grabs it, he will warp to the Otherworld. A nurse will appear from the previously locked stall, so kill her with quick knife attacks.

In the stall where this nurse has emerged, squeeze through the cleft, to the 2F Men's Restroom. Take the First Aid Kit on the wall near the door leading ahead.

Go up the nearby stairs to 3F. Alex may want to turn off the Flashlight for the next part. Break the glass window and hop over into the 3F Day Room. There are two nurses in here, and they are distracted by the TV set. After attacking them from the back or sneaking past them, use the Combat Knife to cut open the flesh-covered cleft near the TV set, and squeeze through it into Room 303. There is a Save Point here.

In the corridor outside Room 303, swarms will attack near the gurney. Slash at them or stomp on them. If they perform their latching brain-suck attack, press the dodge button to yank them off. Proceed to the Linen Room. Take the Health Drink on the shelves.

Next, head to the 3F level of the Operation Theater. Alex may want to turn off the Flashlight for the next part. Follow the walkways, and drop down the ledge to the bottom level. There are three nurses assembled around the operating table. If Alex wants to sneak past them, he must take care not to knock over any loose objects lying around in the dark. Otherwise, suck up the pain and waste all the nurses.

Extra Tip: Alex's life will be completely restored at the end of the hospital section, so try not to waste too many life-restoring items.

Slaying or avoiding the nurses in the Operating Theater, cut open the flesh-covered cleft on the other side of the operating table, and squeeze through it into the nearby stairwell. Go up the stairs to the upper dead end. Take the Operating Theater Key from the corpse half. Backtrack to the bottom level of the Operating Theater. Use the Operating Theater Key to unlock the double doors.

Finding the Toy

Move to the corridor outside the 2F Operating Room to find Joshua again on the other side of another locked gate. The little snot keeps talking about his toy, Robbie the Rabbit, so Alex has no choice but to bust his own butt looking for it. Get to the Nurse's Center. Take the Health Drink on the counters. There is a Save Point here.

Continue to Room 203. The window this time is a hellish wall that has a perpetually bleeding hole in it, into which the toy rabbit is pulled. Looks enticing. Walk right up to this hole, reach in, and prepare to complete the displayed-button sequence to avoid getting an arm ripped off. Alex will automatically take the Robbie figure.

With the toy rabbit obtained, backtrack to the gate with Joshua, watching out for swarms in the corridor on the way to the Nurse's Center. Use the Robbie figure to unlock the gate.

Skip down to the end of the corridor, to the 2F elevator door. Press the button on the walls there to call down the elevator. Hey, what's up with that scraping noise?