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An Offering to Evil is the second Nameless Hospital ending. Complete The Price of Betrayal first so that the Staff Elevator Card opens the elevator.
Enter the anomaly through The Hospital: at Hethereau Municipal Hospital on Onion Road in Illusion Town, turn left from reception into the stairwell. Speak to the Nameless Client facing the corner and choose "(Close Eyes)".
Collect Surveillance clues
From the start, turn left into the hall and enter the door that closes by itself. Follow the zigzag route between shelves to the wooden mannequins and collect the first Surveillance Record clue. Use the elevator across the corridor to reach 2F.
Turn right from the elevator and continue to the windows and blood-marked wall. Turn left, continue to the next bloody wall, then turn left again. Enter the room marked by a red glowstick on the floor. Take the clue between the monitors, flip the switch by the door and collect the 2F Keychain from the bulletin board.
Leave the room, turn right and enter the first door on the right to reach the maintenance room. Take the third Surveillance clue from the book pinned to the bulletin board left of the entrance.
Return to the video room
Leave the maintenance room, turn left, then turn right at the corner and continue to the reception lobby. Defeat the three ordinary enemies and enter the door behind the desk. Place Anomaly Surveillance Clues I, II and III on separate projectors to trigger the ending.