Silent Hill 4: The Room Codes -

Endings:
To get different types of endings, you must do one of four things. Either clear your apartment of ghosts before the final battle, or do not; and let Eileen die or not. These two course of actions create four different endings.

Finish the game four times and earn the four different endings. Play the game again using the same save slot and select Eileen's nurse uniform. If you complete the game a fifth time, hold + before the ending to see the special UFO fifth ending.