Interactive tool
Animal Hospital is a spot-the-difference horror shift: most visitors are ordinary animals, but a few are anomalies — monsters wearing a familiar face. This is the fastest way to make the admit-or-reject call: tick what you actually see at the window, in the check-in photo, on CCTV or on the paperwork, and the tool returns an instant verdict from the in-game five-point check.
Patient anomalies arrive at the check-in window and only get in with your permission; monsters roam the halls and can't be screened away — both are covered below.
On this page: Identifier tool · Every anomaly · Monsters · Five-point check
Tells are compiled from community wikis, patch notes and gameplay (June 2026). Anomalies change with updates — when in doubt, reject and verify against the live game.
Every confirmed patient tell, grouped by where it shows up — at the window, in the photo, on CCTV or on the paperwork. Search by name or symptom, or filter by detection channel. Roaming monsters are listed separately below.
Reference pictures are stylised illustrations of each tell to show you what to look for — not in-game screenshots. Always confirm against the live game.
At the windowThree glowing red eyes instead of the usual two.
The extra eye is often slightly mismatched in size or height, and the patient's real eyes are sometimes still visible behind the glow. Almost always paired with a low, distorted voice.
▶ Reject on sight — always an anomaly, no further checks needed.
At the windowTwo uneven glowing eyes over a crooked, sharp-toothed grin.
The eyes sit at clearly different heights and the mouth is a menacing, distorted smile full of sharp teeth. A low-pitched voice confirms it.
▶ Reject — close the shutter.
At the windowDark empty eye-sockets and a wide, frowning mouth.
Two black holes where the eyes should be, usually twitching. Linked to the Head Banger; during its recovery stage it guarantees a Death Ritual, so it is never safe to admit.
▶ Reject — do not let it inside.
At the windowBig black-pupil eyes, heavy eye-bags and a large drawn-on smile.
One of two 'unnatural face' variants. It loses its real face and keeps staring at you as you move. A distorted voice confirms it.
▶ Reject immediately — no camera check required.
At the windowSmall wide eyes with a set of realistic human teeth.
The second 'unnatural face' variant — an unsettlingly human mouth on an animal. Stares at you and speaks in a low, distorted voice.
▶ Reject — don't bother checking it in.
At the windowArms, head or neck jerk in sudden, sporadic movements.
A genuine patient stands still. Watch for a full four to five seconds — the twitches can be very quick, and sometimes only show on CCTV.
▶ Reject — cross-check the camera if you're unsure.
At the windowStands hunched, sometimes with an elongated neck.
Almost never seen on a real patient and usually paired with twitching. It can also look different again through the camera.
▶ Reject — usually travels with another tell.
A deep, low-pitched, distorted voice at the window.
Bundled with most appearance anomalies — three eyes, mismatched eyes, the unnatural faces. If the voice is wrong, the patient is wrong.
▶ Reject — a near-guaranteed audio tell.
PhotoThe developed photo shows a different model than the live animal.
A different colour, different markings, different horns or even a completely different animal. Compare the photo against the patient in front of you.
▶ Reject — trust the mismatch.
PhotoThe photo's eyes differ from the live animal's.
The change can be subtle — an extra eyelid, or a pupil present in one and not the other. Look closely before you decide.
▶ Reject — small eye differences still count.
PhotoThe photo's ears differ from the live animal's.
Usually more obvious than the eye differences — a different shape, size or set of ears — but still worth a careful side-by-side look.
▶ Reject.
PhotoA normal-looking patient whose photo shows a grotesque face.
The live animal looks fine, but the developed photo reveals a toothy grin, uneven eyes, a human mouth or a heavily blurred face. This is why you photograph every patient, even the calm ones.
▶ Reject the moment the photo turns.
PhotoGrainy static obscures the developed photo.
As of 6/22/26 static alone no longer guarantees an anomaly — with no other tell the patient may be real (shooting them just makes them faint). Treat it as a prompt to look harder, not a verdict.
▶ Confirm with a second sign; when unsure, reject (over-rejecting is safe).
PhotoBloodshot eyes and a grotesque grin in the photo.
Reading a cursed photo costs 10 Sanity, so let it develop on the desk and judge it there first. If it looks wrong lying down, close the shutter without ever picking it up.
▶ Reject — never pick up a cursed photo mid-process.
PhotoThe photo never develops, while the next patient's does.
A dead, unrenderable photo is itself the tell — confirmed when the following patient's photo resolves normally.
▶ Reject — treat the blank photo as a fail.
CCTVA black rectangle over the face with fake eyes drawn on top.
Only shows on CCTV; the patient looks normal in person and in the photo. An obvious camera tell once you switch feeds.
▶ Reject.
CCTVElongated, distorted body on camera.
Limbs poke out at strange angles and the shape can change every time you close and reopen the feed. Holding the photo while on CCTV makes it look stretched too.
▶ Reject — reopen the feed to confirm.
CCTVEmpty eye-sockets visible only on the camera.
The same hollow face can appear on CCTV alone, and it's easy to miss if the patient isn't facing the lens. Use the waiting-room camera for a clear look at the eyes.
▶ Reject.
CCTVLooks dead into the CCTV at all times.
A genuine patient stares ahead toward the office, never at the camera — even while walking. Direct eye contact with the lens is the tell.
▶ Reject.
CCTVThe whole body is solid black on camera.
Every feature is erased, which makes it one of the easier camera tells. A rarer 'disfigured void' variant is partly malformed and even easier to catch.
▶ Reject.
CCTVShows as a sharp-toothed, long-tongued Skinwalker only on camera.
Wide jaws, sharp teeth and a lolling tongue that appear on CCTV but not in person or in the photo, and only once it reaches the check-in spot. Use the lobby/waiting-room camera for a side view.
▶ Reject — never admit a camera Skinwalker.
CCTVEars or eyes differ on camera versus at the window.
The hardest tell to read — the cameras sit far from visitors and only the waiting-room feed shows the eyes. Note the ear and eye shape in person first, then compare on camera.
▶ Reject — check the waiting-room camera specifically.
CCTVTwitches only on the security camera.
Looks perfectly still in person and in the photo but jerks on CCTV. Watch the feed for a full four to five seconds or you'll miss it.
▶ Reject.
Looks perfectly normal but isn't on the appointment list.
Some anomalies pass every visual check. The clipboard is your backstop — if there's no booking for this patient, they shouldn't be admitted.
▶ Reject — always check the appointment list.
Clipboard details don't match the animal in front of you.
Species, name or appointment details that contradict the live patient are a tell in their own right — cross-read the clipboard before you open the shutter.
▶ Reject.
Not every threat queues at the window. These roam the hospital itself, draining Sanity on contact or sight — and most can't be tasered or shot. Only the Skinwalker dies to weapons; the rest need the specific counter below.
Emerges from an anomaly you admitted by mistake, at any point after check-in. It roars as it appears — play with sound — then hunts patients and staff.
▶ The only enemy weapons work on: gun or taser, or bare fists (E) at the cost of Sanity.
Hides under a treatment-room bed with black hands, marked by a red box on the floor. Step in the box and it drags you under for Sanity damage.
▶ Hold Maple Syrup and approach — it takes the syrup and lets you work the room safely.
A hollow-faced figure that walks to the check-in glass and bangs its head until the glass cracks. While it's there you can't use the shutter to reject anyone.
▶ Give it coffee or food to send it off — or wait it out; forcing it away empty-handed costs heavy Sanity.
A tall black figure that lurks around corners and drains Sanity if you look directly at it.
▶ Weapons don't work — break line of sight, avoid eye contact and keep moving.
A weeping mass of eyeballs on the ceiling of a treatment room. It drains Sanity steadily for as long as you look at it.
▶ Easiest counter: keep your camera down. To remove it, offer Eye Drops — open the door facing inward, stand on it and slowly look up until the Accept Treatment prompt appears.
A large purple tentacle that emerges from a patient during surgery in Room 8. Rare, and on a timer.
▶ Just finish the surgery before the timer — do NOT shoot or taze it, or the patient dies instantly.
Appears inside a broken CCTV feed and slowly zooms in, draining Sanity the longer you watch — and it can be fatal.
▶ Press the Exit button to leave the feed in time, then repair that camera so it's safe again.
Camouflaged against windows, curtains and walls; they emerge and attack if you get too close. You can still spot their eyes and smile against the surface, and they breathe loudly — usually in groups of three.
▶ Keep your distance, or clear them with a gun or taser.
Verified June 2026 against community wikis and gameplay. Enemy behaviour can change with updates — confirm against the live game.
Run the five-point check — window, photo, CCTV, paperwork and audio. A single confirmed tell means reject: close the Shutter. The Anomaly Identifier above gives you the verdict the moment you tick a tell.
Yes. Wrongly rejecting a real patient costs a little score but never spawns a Skinwalker. Wrongly admitting an anomaly can wipe the whole shift, so when in doubt, reject.
Yes. It's built mobile-first and runs in any browser on phone, tablet or PC — keep it open on a second screen while you play on Roblox.