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Alchemilla Hospital

"Everyone seems to have disappeared. And it's snowing out. This time of year. Something's gone seriously wrong."

First Floor Reception Hall

Inside this already disturbing hospital you'll find a Save Point on the Reception desk. Take note of the map on the wall that you can't reach from this side and you'll hear another gunshot deeper into the hall. The double doors at the end are jammed so pass through the left door.

Harry meets Dr. Michael Kaufmann who kindly introduces himself with another gunshot, but thankfully he's a terrible shot. Once he leaves, pass through the empty Office on Harry's left to get behind the Reception counter where you can grab a First Aid Kit on a box and the Hospital Map posted on the information board.

Pass back through to the Examination Room you met Kaufmann in and enter the Medicine Room through the far door. There's only a newspaper clipping in here which Harry won't bother to read, so exit from the other door to the east hall.

First Floor East Hall

Enter the Doctor's Office to find the Hospital Basement Map near the other door. Through that door is the Conference Room which holds the 23 Basement Key on the other side of the conference table. Leave both rooms and enter the Kitchen next door, where you can begin a brief optional quest segment.

Optional Quest: Unknown Liquid (Kitchen and Director's Office)

Boss 1: Split Head Lizard Just ahead in the far corner of the Kitchen the angle will shift, hinting at some bottles in the foreground. Examine them for a 24 Plastic Bottle. Find the Health Drink on the other side of the island and exit the room.

Inside the Director's Office you'll come across a trashed room with a smashed vial of red liquid behind the back desk. Not really knowing what it is, you can use the Plastic Bottle to take the 25 Unknown Liquid.

Acquiring the Plastic Bottle and Unknown Liquid is entirely optional, however they are required to have any shot at receiving one of the + endings (Good+ or Bad+) by using it at the right time and place. I suggest just playing normally and receiving your natural ending but you can always read more about it in the Endings section.

Back out in the hall, the elevator isn't functioning so the power must be out. Let's see what the problem is by accessing the basement stairway beside it with the Basement Key.

Basement

Enter the basement down the stairs and take care of the Creepers if they bother you. Enter the Generator Room and examine the panel to find a note informing you what it powers, with the elevator among the list. Turn on the generator and leave the room. Now you can access the elevator from the basement or first floor.

Elevator

Inside the elevator, ascend up to 2F to find the hallway doors jammed. Proceed up to 3F to find the same. Upon checking the elevator panel again however, is a terrifying surprise... Clench your butt cheeks and hit that 4 button.
05. Central Silent Hill 07. Nightmare Hospital