By the Animal Hospital Anomaly Wiki team · Updated 2026-06-26

Interactive tool

Animal Hospital Anomaly Identifier

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

How to use it: a single confirmed tell is enough to reject. Work the tabs in order — Window → Photo → CCTV → Paperwork & Audio — and hit the Shutter the moment anything is checked. Appearance tells also show up in the photo and on CCTV, so you can double-confirm a window tell on camera before you commit. Keep this open on a second screen while you play.

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 anomaly in Animal Hospital — full list

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.

At the window

Three Eyes

Three 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 window

Mismatched Eyes & Sharp Teeth

Two 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 window

Hollow Face

Dark 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 window

Wide Eyes & Drawn-on Smile

Big 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 window

Human Teeth

Small 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 window

Twitching

Arms, 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 window

Hunched Posture

Stands 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.

Audio

Distorted Voice

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.

Photo

Incorrect Photo

The 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.

Photo

Different Eyes (Photo)

The 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.

Photo

Different Ears (Photo)

The 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.

Photo

Unnatural Photo

A 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.

Photo

Static Photo

Grainy 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).

Photo

Cursed Photo

Bloodshot 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.

Photo

Unprocessed Photo

The 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.

CCTV

Censored / Black-box Eyes

A 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.

CCTV

Unnatural / Stretched Body

Elongated, 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.

CCTV

Hollow Face (CCTV)

Empty 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.

CCTV

Staring at the Camera

Looks 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.

CCTV

Void / Black Body

The 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.

CCTV

Skinwalker on CCTV

Shows 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.

CCTV

Mismatched Ears/Eyes (CCTV)

Ears 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.

CCTV

Twitching (CCTV)

Twitches 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.

Paperwork

Missing Appointment

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.

Paperwork

Wrong Paperwork Details

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.

Monsters & enemies in the hospital

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.

Skinwalker

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.

Bed Monster

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.

Head Banger

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.

Stalker

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.

Mass of Eyes (“Don't Look Up”)

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.

Surgery Tendril

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.

Camera Figure

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.

Hiders

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.

The five-point check, in order

  1. Look at the live animal — eyes, teeth, posture, twitching.
  2. Photograph it and compare the snapshot to what's in front of you.
  3. Switch to CCTV — some anomalies only break on camera.
  4. Read the clipboard — is the appointment actually booked?
  5. Listen — a low, distorted voice is a near-certain tell.
The safe error is always rejection. Wrongly rejecting a real patient costs a little score. Wrongly admitting an anomaly plants a Skinwalker inside your clinic that can wipe the whole shift.

How anomalies behave (once one's inside)

  • They crave coffee. Some anomalies will accept coffee at the window — and per Dr. Harlow, they hate having their photo taken, which is why the camera is your best tool.
  • A healed anomaly says "I'm Hungry," then either leaves or attacks another patient. Treating one is never a safe shortcut unless you mean to kill it.
  • Wrong meds kill an anomaly safely. Killing a disguised patient with the wrong treatment costs you no points — a quick way to clear one you admitted by mistake.
  • Shift summary won't appear? If you've treated everyone and the end-of-shift screen doesn't show, an anomaly is still hiding among your patients.

What changed recently

  • 6/23/26 — Bandages recoloured red → green (the red cross is a protected symbol); the cure itself is unchanged.
  • 6/22/26 — A static-only photo no longer guarantees an anomaly; with no other tell the patient can be real, so confirm before rejecting.
  • 6/17/26 — Fire Extinguisher charge reaching 0% no longer blocks its use (treated as a bug).

We log dated changes so you can see this page tracks the live game. Spotted one we've missed? It belongs on our sources page.

Frequently asked questions

How do I know whether to admit or reject a patient?

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.

Is it safe to reject a real patient by mistake?

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.

Does the Anomaly Identifier work on mobile?

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.