Health officials said an Israeli airstrike and tank shelling killed six Palestinians, including two girls, in Gaza City on Sunday in two separate attacks.

Mohammed Abu Salmiya, director of Al-Shifa Hospital in Gaza City, said three of the victims were killed near Al-Azhar University in western Gaza, including paramedic Mohammed Hamdouna, along with Mohammed Abu Shdaq and Ahmed Lafi.

Medics said the airstrike targeted an area near crowded camps where Gaza residents are sheltering, also injuring several people.

Gaza’s Health Ministry said that at least 640 Palestinians have been killed by Israeli fire since a ceasefire agreement between Israel and Hamas, mediated by the United States, came into effect last October.