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Or is it just one of Phil's balls in my throat?

SILENT HILL f - ESRB
SILENT HILL f - Mature 17+ - SILENT HILL f is rated M for Mature 17+ by the ESRB with Blood and Gore, Intense Violence, and Partial Nudity.

edit: Some of the ESRB things might be scenario spoilers, so tagging it under spoiler tags.

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