An Israeli tank shell hit the third floor of Al-Aqsa hospital in the central Gaza Strip on Monday, killing four people and wounding 16, Health Ministry spokesman Ashraf Al-Qidra said.
The spokesman said the third floor housed an intensive care unit and operating theatres. Other shells had fallen around the hospital, he added, with officials calling on the Red Cross to help evacuate patients.
The Israeli military had no immediate comment. In the past it has accused Hamas Islamist militants of firing rockets from the grounds of Gaza hospitals and of seeking refuge in the buildings.
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