Location: Randomly appears on the ceiling of the patient ward or reception area.

Unlock Method: When the Don't Look Up warning appears on the screen, deliberately look up and stare directly at the giant eye on the ceiling for a few moments. Merely seeing it isn't enough—you must keep your gaze fixed on it until the event triggers.

Tip: You can use Eye Drops or an IV to mitigate the subsequent loss of Sanity. This is one of the easiest anomalies to unlock; you simply need the courage to disobey the warning.

Location: Appears at the spot where a patient has died.

Unlock Method: Allow the ghost to approach and attack you; once you take Sanity damage, the Ghost entry will be recorded in the Journal. You can then eliminate it using a Taser, pistol, or scanner.

Tip: The Ghost is one of the few anomalies that requires you to actively take a hit to unlock. It is best to attempt this when your Sanity is high to avoid a shift failure caused by your Sanity dropping to zero.

Location: Peeks at the player from corridor corners or room doorways.

Unlock Method: Once you spot it, simply look directly at the Stalker. You will lose 10 Sanity points; this is one of the easiest anomalies to unlock.

Location: Any anomalous patient you refuse to admit will eventually transform into a Mimic after some time.

Unlock Method: Let a Mimic attack you (losing 6 Sanity) or successfully rescue a teammate or patient while they are being attacked by one.

Tip: This is easier to complete in multiplayer mode—rescuing a teammate after they are attacked allows you to unlock the entry without taking excessive damage yourself.

Location: They camouflage themselves against the walls of patient rooms and corridors, blending into the environment; only their glowing eyes and smiles are visible.

Unlock Method: Approach a hidden Hider on the wall to trigger its attack and let it grab you (losing 10 Sanity).

Tip: Look closely for unnatural glowing spots on the walls—that indicates the Hider's location.

Location: Lit candles appear around a patient's bed, rapidly draining the Sanity of nearby players.

Unlock Method: Normally, you would extinguish the candles with eye drops to stop the ritual. However, to unlock the entry, you must interact with it bare-handed (without using eye drops) while the ritual is in progress.

Tip: The Ritual is a timed emergency event. If you only want to unlock the entry, you can intentionally let the ritual complete (resulting in the patient's death), but be aware that this counts toward your death limit.

Location: Usually appears starting from the 2nd or 3rd shift; it stands outside the reception window and bangs its head against the glass.

Unlock Method: The Head Banger wants a cup of coffee; choosing not to give it one unlocks the entry (at the cost of 20 Sanity).

Tip: You will lose a significant amount of Sanity, so prepare accordingly.

Location: May appear when viewing a malfunctioning security camera (one showing static/snowy noise).

Unlock Method: Do not repair the malfunctioning camera. Continue viewing its feed on your tablet and let the monster gradually approach until it triggers a jump scare.

Tip: This is one of the few anomalies that requires inaction to unlock. The malfunctioning camera is characterized by static interference on the screen—simply locate such a camera and watch the feed continuously to trigger the entry.

Location: A red zone appears under the patient's bed when they are in an abnormal state.

Unlock Method: Step into the red zone under the bed, let the black arm grab you, and suffer an attack from the Bed Monster.

Tip: Feeding it maple syrup drives the Bed Monster away; this can serve as a way to resolve the situation.

Location: Tentacles sprout from the patient's body during surgery in Operating Room 8.

Unlock Method: Witness the event to record the entry. Do not attack the tentacles with the taser or pistol, as doing so will kill the patient.

Tip: Observe calmly and do not attack the tentacles. You have 45 seconds to handle this emergency event.

Location: Produced by the patient; appears randomly.

Unlock Method: Let the Slime Bot consume you. You will initially lose 20 Sanity points, followed by a loss of 3 Sanity points per second. You can use a fire extinguisher or cough syrup to make it disappear faster.

Barney is one of the game's main antagonists—a white, rabbit-like creature wearing a brown hat and plaid trousers. He appears during early shifts. Initially, he simply asks for coffee, but subsequently makes a series of requests: taking a photo, hiding a briefcase (without opening it), providing a scalpel, and finally, asking to hide at the reception desk for a round. Officer Duckman will then appear and ask for Barney's whereabouts. You have two choices:

• Ending A (Report): Hand Barney over to Duckman. The officer attempts to arrest Barney but is knocked unconscious; you must then treat him.
• Ending B (Shield): Let Barney continue hiding and tell the officer you haven't seen him. Barney will reward you with a second coffee machine, which is extremely helpful for managing your Sanity.

Tip: Both endings unlock Journal entries, so you won't miss out on any records regardless of the path you choose. However, since the second coffee machine is highly practical, it is recommended to choose to cover for Barney during your first playthrough.

Liz is a former Animal Corp journalist who was fired for digging too deep into the anomalous infection incident. She appears at the reception window after Shift 10, asking for your help to photograph specific patients using a special UV camera. She will assign you a total of four photography tasks; completing them all grants you all the associated rewards.

Tip: Liz will mention the target patient's name—remember it! When that patient arrives at the window, you must take their photo using the UV camera. If you photograph the wrong person or miss the opportunity, Liz will stop cooperating with you.

Ratthew is a recurring patient who visits multiple times during the early shifts. If you treat him properly each time, he will gradually come to trust you; eventually, he will step behind the reception desk, sit down, and engage in a long conversation recounting the story of his missing sister, Rattina.

After the conversation, Ratthew leaves behind a key. This key opens a hidden safe behind the poster in Room 5, unlocking a hidden story segment and completing the entry.

Tip: Ratthew’s storyline requires multiple treatment sessions—take each one seriously; don't get sloppy just because he is a regular.

Dr. Harlow is the mentor figure at the start of the game who appears after you register and treat the first three patients. He introduces the basic mechanics and warns you of the impending first anomalous attack. To complete his Journal entry, you need to give him mint tea.

Ron is a male lop-eared rabbit NPC; he is neither an anomaly nor a monster, appearing purely to share his backstory. Like Ratthew, you must listen to the full dialogue during both his initial appearance and his final interaction.

Sam is an NPC added in the latest update who appears automatically after the Slime Incident is triggered. Simply admitting him into the hospital completes the entry.

Requires surviving a specific number of shifts: 10, 25, 50, and finally 100. Rewards increase with each milestone, capping at 250 Animal Coins. Since shifts are infinite, you can theoretically keep progressing indefinitely.

Tip: As the shift count rises, the frequency and intensity of anomalies increase. Playing in a team is recommended to boost survival rates.

Requires treating a cumulative number of patients, starting at 25 and scaling up to 500; rewards range from 5 to 25 Animal Coins.

Tip: Focus on rapid treatment during early shifts; don't obsess over a perfect score—speed is the priority.

Specific actions performed during certain shifts, anomaly events, or encounters with special NPCs unlock these achievements. There are many such entries, so check your locked achievements before and after games, and keep an eye out for opportunities to perform the required actions during gameplay. We have compiled these entries and their unlock conditions into the table below for easy reference.