The Hamas government's deputy health minister Youssef Abu Rish said the death toll inside Al-Shifa rose to 27 adult intensive care patients and seven babies since the weekend as the facility suffered fuel shortages.
At least 650 patients were still inside, desperate to be evacuated to another medical facility by the Red Cross or some other neutral agency. Israel says the hospital sits atop tunnels housing a headquarters for Hamas fighters using patients as shields, which Hamas denies.
"The tanks are in front of the hospital. We are under full blockade. It's a totally civilian area. Only hospital facility, hospital patients, doctors and other civilians staying in the hospital. Someone should stop this," a surgeon at the hospital, Dr Ahmed El Mokhallalati, said by telephone.
"They bombed the (water) tanks, they bombed the water wells, they bombed the oxygen pump as well. They bombed everything in the hospital. So we are hardly surviving. We tell everyone, the hospital is no more a safe place for treating patients.
We are harming patients by keeping them here." There was also fresh concern that the war could spread beyond an upsurge of clashes on Israel's northern border with Lebanon, and the United States launching air strikes on Iran-linked militia targets in neighbouring Syria.
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