Where this list actually comes from
This is our reconstruction, not an in-game audit, and you should read it that way. We did not sit in the game and record every patient. We read the public community write-ups, kept a sign when more than one write-up that had clearly not copied the other described it, and left out anything that appeared in exactly one place. That is a reasonable way to build a list. It is not the same as knowing.
So the honest summary is: the checker is a memory aid, not an oracle. It can be wrong, it is definitely incomplete, and a clear result from it does not mean the patient is safe. Your eyes at the glass beat our table every time.
We also drew a deliberate boundary. This site catalogues the signs used to identify a patient before you admit it: 6 appearance tells, 5 photo tells, 7 CCTV tells. The monsters and hazards inside the hospital are a different mechanic, and folding them into an identification list makes the list longer and worse.
We got that boundary wrong twice, and both were caught by re-reading the sources on 2026-07-14. Head Banger was counted as an appearance tell, and the red-eyed figure on the camera feed was counted as a CCTV tell. Neither is a patient you admit or reject — the write-ups file both with the monsters. They are still in the database, because you do meet them, but the checker no longer offers them as signs and they are not counted as tells.
We also went looking for what we were missing, and found two real gaps: Different Eyes and Unnatural Photo are separate photo tells that we had wrongly folded into one entry. Both are now in the list. Several other names that look like missing anomalies turned out to be other guides' names for tells we already had — "Censored Eyes" is Black Eyes, "Disguised Shapeshifter" is the Skinwalker.
Two honest limits. First, the tier list ranks these by how easy they are to miss and how badly a mistake hurts. That ranking is our judgement call, not data pulled out of the game and not something we measured by playing. Second, Animal Hospital is actively updated. If a shift shows you something that is not in the catalogue, the likeliest explanation is that our list is behind the game, not that you imagined it. Tell us, and we will go and check.
Why the order of the checks decides the run
Look, photograph, monitor, decide. The sequence matters more than memorising individual tells, because the three anomaly categories hide in three places that do not overlap.
An appearance anomaly is visible at the glass. A photo anomaly is invisible at the glass by design — that is the entire point of it. A CCTV anomaly is invisible at the glass and in the photo. So a patient that survives your eyes has told you almost nothing about what the camera is going to show, and 7 of the 18 tells we track appear nowhere else.
This is why "it looked normal" is not evidence. It is the absence of one of three kinds of evidence. The only sentence that justifies opening the door is: it looked normal, the photo matched, and the feed was clean. Skipping the camera because the patient seemed fine is not a shortcut, it is the exact hole the CCTV anomalies were built to walk through — and it is the mistake that shows up most when a shift starts running late.
The three anomalies that actually get through
Most of the catalogue is loud. A glowing red third eye, empty hollow sockets, a body that goes solid black on camera — nobody waves those through. The ones that end runs are the quiet ones.
Human Teeth is the worst offender. The patient behaves completely normally. Nothing about its posture or movement is wrong. The only thing wrong with it is the mouth, which is why we now check the mouth on every patient rather than only on the ones that already look strange.
Different In Photo asks you to notice that the processed image has altered ears, eyes, colour, or shape versus the animal at the glass — and the difference can be small. The fix is to make the comparison mechanical: check ears, then eyes, then colour, then shape, as four separate looks. Asking yourself whether the photo "feels" different produces a no every time under pressure.
Different Ears is the same trap, and we had it wrong until 2026-07-14: we described it as camera-only. It is not. Every source we checked places mismatched ears in the photo as well as on the feed, so compare the ears at both steps. Telling you to only check the cameras for this one is exactly how a player waves it through.
What it costs you to admit one anyway
Not every anomaly has a documented consequence, and we do not invent one where a source has not shown it. But several are specific enough to be worth knowing before you gamble on a borderline call.
Admit Three Eyes and it can spawn hostile monsters loose in the hospital. Admit Human Teeth and it triggers a death ritual, or the patient turns into a shapeshifter. Admit a Skinwalker — the wide mouth full of sharp teeth that only the cameras show you — and it becomes a hostile Skinwalker inside the building with your team.
Two more punish you without being admitted at all. Black Body, Red Eyes drains sanity and zooms the feed in while you are still looking at it, and Cursed Photo takes 10 sanity the instant you look at the developed image. Neither of those changes the decision. Reject, and stop staring at the evidence.
The pattern across all of them is the same: a correct reject at the window costs you a few seconds, and a wrong admit costs you the rest of the shift. Those two are not close.
Where your sanity actually goes
Sanity is the quiet timer behind every decision. Health and monsters are obvious; sanity loss changes how your team behaves before the run ends, which is far more dangerous.
The big scripted drain is Cursed Photo at 10 sanity per look. Head Banger — the hazard that bangs its head against the reception glass — drains you if you interact with it unprepared, and the correct play is to wait for it to leave or give it coffee rather than improvising. Beyond those, most of what drains a team is self-inflicted: staring at disturbing evidence longer than the call required, flipping feeds four times to re-prove a decision you had already made, or panicking because nobody said what failed.
Recovery items are not trophies. Use coffee or food before the bar is nearly empty, because the last few points of sanity are exactly when players start making desperate calls. An item still in your inventory at that moment is an item that failed to do its job. The sanity guide has the full breakdown of drains and recovery timing.
Codes, and why we do not publish a list
Animal Hospital has no code redemption box. There is nowhere to type a code, which means every "working code" list you find for this game is describing a feature the game does not have.
We keep a codes page anyway, because the question is reasonable and someone should answer it honestly. It records the current status, the date we last checked it against the game's own Roblox page, where real codes would be announced first if the developer adds them, and how to spot a fabricated one. The moment a redemption box exists, that page gets real codes and real redemption steps.
Until then, the time you would spend hunting codes is better spent on the checker and the quiz. Learning the appearance, photo, and CCTV tells will save more shifts than any code would have.
The mistake no tell list warns you about: screening a hazard
Every "complete anomaly list" for this game treats all 20 entries as patients you judge at the window. They are not. 18 are identification tells you admit or reject; the other 2 — Head Banger at the glass and the red-eyed figure on the camera feed — are the two entries the checker deliberately withholds as signs, because they are hazards you handle, not patients you screen. If you catch yourself trying to admit or reject either one, you have mistaken a hazard for a patient. With the red-eyed figure that has a direct cost: holding the feed on it to "confirm" the call is exactly what drains your sanity as the camera zooms in, so the documented play is to turn the feed off rather than keep watching. Head Banger has its own answer — wait for it to leave or give it coffee rather than interacting with it unprepared. Neither belongs in an admit-or-reject decision, so when a name is unfamiliar, open the full anomaly database to check whether it is listed as a patient tell or flagged as a hazard, and keep the printable tell cheat sheet on a second screen so that line never blurs mid-shift.
From the blog
Longer write-ups where a section here was not enough room.
- How to check a patient before you admit it — The three-check routine in the order it has to run, and the tells that slip through when you rush it.
- Which class to buy first with Animal Coins — A buy order based on the job you actually do on a shift, not on the price tag.
- Shift 7 survival: splitting the desk — Why runs fall apart around Shift 7, and the three-role split that holds the standard.
Sections on this page last updated 2026-07-14. The anomaly list is our own reconstruction from public community write-ups, not an in-game audit — see above.