Saw
46 Achievements
1,000
8-10h
Xbox 360
Who Is The Jigsaw Killer?
Find your first Patient File.
15
How to unlock the Who Is The Jigsaw Killer? achievement in Saw - Definitive Guide
In the first level, after listening to your first Audio Tape and after the fight with your first NPC, take the key off of the minion's body and go into the room he came out of. On the table/cart is your first Patient File. There are more throughout the game, but you only need one for the achievement and this is the first one you have access to.
Just like with the Asylum files, you will find these scattered throughout the Asylum. You only need to find one in the whole game.
After killing the first NPC in the game, go into the red-lit room that he broke out of to attack you. This file is sitting on a box in the corner.
There are also plenty of these in the game, but again you don't need them and can ignore them after grabbing this if you so choose.