Some thoughts. Insulate well, and then you need a lot less A/C. Solar panels, as much as you can. A couple of folding 200w panels and another MPPT you can plug them into while parked doesn't take up THAT much space, compared to what the extra batteries that might represent could be, and then you also have less worries about where you park, because you can drag the panels into the sun and park in the shade and still be getting 300-400w charging much of the day (probably an extra 1-2kwh a day). Light colors for the ambulance paint! White roof helps a ton. Both reducing solar gain, and also if you use bifacial solar panels on the roof, you'll get another 10-20% of solar power out of them.
For a water heater, look at a marine diesel water heater that also takes a 300w heating element. You can use the electric heating element as a dump zone once the batteries are fully charge, and run it off diesel otherwise. That would likely save you 1-2kwh on battery load. Diesel is a lot more energy dense than batteries are, so a gallon fuel tank for the diesel heater is going to represent 5-10kwh worth of batteries, easy. Or since it is a diesel truck anyway, tap the fuel tank and then you don't need to take up space with a propane tank, or diesel tank for a water heater.
Consider looking at a DC powered minisplit. Running your A/C inverter all day long, just to provide power for your A/C is going to kill .5-1kwh per day (1-2kwh per 48hrs). AND you are losing efficiency converting DC to AC, and then likely back into DC in the minisplit (assuming an inverter based minisplit). There you are talking probably 10-15% efficiency losses versus a straight DC mini-split. So overall, if you are talking 48hrs of use, no charging at all, figure a loss of 3-4kwh by going with an A/C mini-split.
Solar panels weigh more than the batteries you could have, but do not take up space inside, and frankly, 100-140lbs of panels on the roof isn't all that much extra weight, even up high. Extra insulation isn't going to take up much space inside, compared to the efficiency gains you'd get. Light color paint adds a bunch more. Going with a DC based A/C is going to add a ton of efficiencies. A diesel water heater a bunch more too.
Overall, you can easily shave half the size/capacity/weight of your batteries. Even if you are sticking to hot and humid environments for ambulance life, you could likely get away with 10kwh all day long (and the next too) with that approach.
I am still a few years away from something like this myself (though going transit route) and doing as much research as I can, I am personally looking at around a 500-600ah 12v system, approximately 1000w on the roof, a 30a DC-DC charger, Victron system, 3000va Multiplus II, diesel marine water heater with 300w heating element, DC 12v ductless mini-split, very well insulated. I WILL likely either tote my Sportsmans 1000i suitcase inverter generator, or just as likely I'll look for a new 1200-1400w suitcase generator. That Sportsmans 1000i can probably get the job done, but figuring in losses and 75% max load, that is really only maybe 550w into the batteries. 10-12hrs to recharge the bank from 0 is a mighty long time if I am trying to do it off that generator (worse off the DC-DC charger, but that DC-DC charger is as much just to HELP keep things charged up). A 1400w suitcase generator at 1000w is more like 6-7hrs to charge the battery bank up from zero, which is a lot better. Oh, and 1-2 200-220w folding panels. That should be a day of very heavy AC use with minimal solar power. With good solar in a day, that'll keep everything charged up. At worst, parking in the shade or overcast and hot, A/C use would go down some, but little recharging there. I can always break out the generator once a day for a few hours.