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ill give it a shot. first of the tranny, i have 200k on the original e4od tranny however my truck is much lighter than an ambulance, but i wouldnt let that scare you. if it ever does blow out, you can get a rebuilt one or have it rebuilt for not a crazy amount. the thing you want to do is change the fluid in it regularly, and a big empasis on the shift kit. inside the tranny their are clutches that slip when in between gear changing. stock trannys do it slow and smoothly for ride comfort. what a shift kit does is make the tranny shift faster resulting in less slippage and less parts wearing out.
as far as the frame, they are rediculously strong i dont think youll ever have a problem. I know a few people who have bought ambulances and have worked on them, and theres one problem that should be addressed. you NEED to make sure that when you take off the wheels and put them back on that you torque each bolt EQUALLY and in a star pattern, my freind slapped the wheel back on his ambulance without a torque wrench to make it precise and broke 7 out of 8 studs off from over tighening.
if its a powerstroke motor (direct injection) then there a few things that may leak but are pretty easy to repair in a few hours. Hoever im about 60 percent sure they didnt drop powerstokes in vans in 94 for some reason. i might be wrong. if this is the case then you have a 7.3 idi engine, which is also a very good engine which will get high mileage. the one thing you have to worry about with this engine is the coolant. Diesel engines need a speciall additive in the coolant to prevent cavitation from the high compression. test strips and additives can be found at any auto parts store, just ask for diesel coolant test strips.
the plus side is, if its an ambulance, its probably been maintaned and whenever something has broke its been fixed correctly since they invloce life and death situations and are usually owned by either a wealthy company or a town that has plenty of taxpayer money to spend.
if the price is right go for it, youd be suprise how much equipment you could fit in one of these things. and if you ever run into any problems, we will be glad to guide you in the right direction
2016 F450 6.7L XLT 4x4
Dump, bone stock
1994 F250 7.3L XLT 4x4
ZF5 , Centurion, 4" Lift, 6637, Gulf Coast Bypass Filter, Big fuel tanks, dana 60 swap, No longer dually
1997 F350 7.3L XLT 4x4
Dump, E4OD, 4 in exhaust, TS 6 position, 3/8 Trans line+external filter
2013 Scag Turf Tiger 61" 1.1L Caterpillar Diesel
1960 John Deere 440 Backhoe 2-53 detroit