The Silent Hill 2 Remake Hospital X-Ray puzzle and Combination Lock code on 3F are both linked, as solving the X-Ray and Radiograph puzzle is what gives you the code to the combination lock across the hall and allows you to progress. It's a tricky one that'll take a while to solve properly, as you'll need another radiograph to properly solve the puzzle - yes, the reason you're likely struggling is that there's a whole other puzzle piece, and not only that, it's covered in mold you need to find a way to clean off.
We'll explain how to find all the pieces and solve the X-Ray puzzle of Silent Hill 2 below, as well as lay out the combination lock code. Keep in mind that there's a lot of danger ahead if you're pursuing this route, so if you haven't found the Silent Hill 2 Remake shotgun yet, now might be the time to go grab it so you're well-prepared.
Silent Hill 2 Remake Hospital combination lock code
The code to the hospital combination lock in Silent Hill 2 Remake is 4-37-12 on normal puzzle difficulty. To enter it, turn the lock right, left, right to the three numbers, then press X to "Accept" (it can be a little hard to see the specific digits, so you might have to lean into the screen a little).
The code itself, however, is found by completing the X-Ray Viewer puzzle in the room across the hall. If you want to go through the steps needed to get the full experience, we'll go through it below - though keep in mind that this is a far longer puzzle than the Silent Hill 2 Remake hospital generator you needed to complete to get to this point.
How to solve the X-Ray Viewer puzzle in the Silent Hill 2 Remake
The X-Ray Viewer puzzle in Silent Hill 2 can't be solved when you first find it, as you're missing several essential pieces. The X-Ray puzzle is all about arranging several radiograph X-Rays so that the markings on them reveal the combination to the lock, but you need all of them to reveal the full combination, and you'll have to find - and even clean - the radiographs first. To solve this puzzle, here's the full walkthrough.
- After finding the X-Ray Viewer, immediately make sure you get the Radiograph of a Pelvis on the bed behind you in the same X-Ray Room.
- Get the Keypad Combination Note pinned to the notice board in the 1F Doctor's Lounge.
- Using this information, open the 2F Nurse's Station Keypad with the code 3578.
- Now you need to head through to the 2F Treatment Room next to the Nurse's office.
- In the bath in the corner you'll find the Moldy Radiograph. However, you can't use this in the puzzle yet.
- Head to the 1F Pantry, at the bottom of which you'll find a bottle of Mold Remover surrounded by bugs.
- Combine the Moldy Radiograph and the Mold Remover in your inventory to get the Cleaned Up Radiograph, showing somebody's hand.
- Now with all the Radiographs, head back to the 3F X-Ray Room and go into the viewer, then press "Inventory" to add them to the board.
- Arrange them according to the pattern above to reveal the full combination code.
The key to solving the puzzle is using the little overlaid black marker scratches on both the board and the radiographs to work out where they go, rather than doing what I assumed was the point early on and making a coherent human being from the various X-Rays.
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