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The Roof Key is found in Room S3 on the third floor on Brookhaven Hospital in Silent Hill 2. Upon entering the room, Maria, who accompanied James Sunderland previously, lies on the bed to rest. After the scene, the key is then able to be picked up from a nearby nightstand. The key unlocks the door to access the roof floor of the building where James will discover a patient's diary scattered across the rooftop, and after some time will once again encounter Pyramid Head.