Comments from our Elden Ring Wiki
By Anonymous
Based on the bell bearings page, these are the items offered after turning in the bell to the twin maiden husks:

Gold-Pickled Fowl Foot
Fan Daggers
Margit's Shackle
Grace Mimic
Glass Shard
Furlcalling Finger Remedy
Festering Bloody Finger
Stonesword Key
Missionary Cookbook (2)
Parrying Dagger
Great Arrow
Ballista Bolt
Horse Crest Wooden Shield
Sacrificial Twig
By Anonymous
I don't suppose this can be obtained after Shaded Castle, can it?
By Anonymous
He goes back to Murkwater Cave.
By Anonymous
do you have to kill him for it
By Anonymous
Patches' Bell Bearing can be used to can be used to can be used to
By Anonymous
***********spoilers***************For those who killed Rykard before encountering the members of Volcano Manor, effectively breaking the questline: I found Patches Bell Bearing on the ground near the tower that contains the Pulley Bow. Close to the location with the Glowing Stones. (Note, I had already encountered him there and had him kick me over the ledge.)
By Anonymous
Where exactly is it, so I can't delimit the place ?! :)
By Anonymous
If you kill him after completing his quest, do the twins offer unlimited fan daggers or no?
By Anonymous
Does anyone know if the maiden sells an infinite amount of items? I’m trying to find an easy source of gold pickled fowl foot for farmings and when speaking to patches himself, he only lets me buy 3 total
By Anonymous
no it will always be three
By Anonymous
I'm a fair way through the game, with only 2 Shardbearers left (Rykard dead). I have not seen patches in game, but I went to Murkbarrow Cave as I was trying to explore as much as possible before I finish the game.

I don't know what part of my progress ruined Patches, but after clearing out the cave I did not find him there, just his items on the ground.

If you want to progress his storyline I'm assuming you'll probably have to head there fairly early on.
By Anonymous
Same. No patches for us
By Anonymous
accidentally killed him. I really wanted his gestures, too!