Silent Hill: Townfall: How to Solve the Scales Puzzle

Published: 07:00, 21 September 2026
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Silent Hill: Townfall: How to Solve the Scales Puzzle
The three scales inside St. Amelia's clinic, the centrepiece of this puzzle.
The three scales inside St. Amelia's clinic, the centrepiece of this puzzle.

Three empty scales, three hidden objects, and a letter that quietly tells you exactly where each one goes. Here's how to close out the clinic in St. Amelia.

Silent Hill: Townfall, developed by No Code and published by Konami, has a habit of dropping you in front of a puzzle without ever telling you it's one, and the clinic scales in St. Amelia are a good example. Following the main objective through the Shorefront District leads you to the clinic, where three scales sit waiting. Interact with them and the game marks them on your map, but it never actually spells out that you need to track down three separate items and place them in a specific order. Here's what goes where.

Find the three items

You need three objects to fill the scales, and you may already have one of them without realising it. Zoe's Lanyard comes from the Human Organ Box, which we've covered in a separate guide (see the link above), and it also happens to be what gets you into the clinic in the first place, so there's no reaching this puzzle without it. The Prescription Dosage is the second item, picked up from the locker inside the pharmacy, also covered in its own guide (this one you can find on the link at the bottom of this guide). The third is the most straightforward of the lot: a Broken Stethoscope belonging to Zoe, sitting inside Jess's apartment. No puzzle attached to that one, just go and pick it up, although the way to it is filled with monsters, so be ready to sneak around a lot.

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The Shorefront map showing where all three items are found: the organ box and Zoe's for the lanyard, the pharmacy for the Prescription Dosage, and Jess's for the stethoscope.
The Shorefront map showing where all three items are found: the organ box and Zoe's for the lanyard, the pharmacy for the Prescription Dosage, and Jess's for the stethoscope.

Read Zoe's letter for the order

Once you have all three items, head back to the clinic. Next to the scales you'll find Zoe's resignation letter, addressed to Dr Stevenson, with three lines underlined for emphasis. Each one lines up with one of your items. "I didn't listen closely enough" points to the stethoscope. "I made mistakes and couldn't focus on the tasks at hand" points to the Prescription Dosage. "I'm not fit to work in this role any longer" points to the lanyard, the item tied to her actual job. Read in that order, the letter is effectively handing you the solution.

Place the items on the scales

With the order worked out, place the items on the scales from left to right as follows: Broken Stethoscope, Prescription Dosage, then Zoe's Lanyard. Once all three are set down correctly, a cutscene triggers and the chapter closes out.

Quick Tip: All items can be picked up in natural order, so don't worry that you'll miss something. Once you pick up the lanyard, you'll get access to the clinic; from there, you'll go pick up either the Prescription Dosage from the Pharmacy or the Broken Stethoscope from Jess's.

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