For your specific use ("a man finds all his sins combined—his total—in tangible form"), I think manifestation would work perfectly.
Consider the various meanings of "manifestation" (from thefreedictionary.com):
- An indication of the existence, reality, or presence of something
- One of the forms in which someone or something, such as a person, a divine being, or an idea, is revealed
- The materialized form of a spirit
Note that "manifestation" (and the verb "manifest") often have an otherwordly/supernatural connotation (e.g. the manifestation of a ghost, spirit, deity, etc.) that would mesh well with a person seeing their sins in a tangible form.
On top of that, for the noun "manifest," we have (also from thefreedictionary.com):
- A list of cargo or passengers carried on a ship or plane.
- An invoice of goods carried on a truck or train.
This meaning of "manifest" as a list (invoice) of items (goods, cargo, passengers, sins) carried can rather neatly be applied to the "total/combined sum" of his sins--his sinvoice, if you will. Furthermore, there is a common notion in many religions of "carrying one's sin."
Though "manifestation" lacks an overtly negative connotation, I believe it would work well in the context you described.
Rough example sentence, assuming that the sins have taken a person-like form:
When he opened his eyes, Chad was horrified to see the manifestation of his sins standing over him.