A brazen attack in Logar province, just south of the capital Kabul on Saturday, came a day after another bomb blast killed 10 people in northern Afghanistan.
"A suicide car bomb attacker targeted a hospital in Azra district of Logar province," Din Mohammad Darwaish, the Logar provincial spokesman, said of the latest attack.
"The suicide blast killed 30 people and wounded another 45. The casualties are all patients, their visitors and relatives and hospital personnel."He added: "The blast was caused by an SUV packed with explosives and driven by a suicide attacker.
"The target of the blast is not clear but what is obvious is that a hospital was attacked and civilians were killed."
The head of Logar's provincial council, Abdul Wali Wakeel, confirmed the toll and said local officials had contacted foreign forces to ask for help in evacuating the wounded.
A spokesman for the NATO-led International Security Assistance Force (ISAF) in Kabul said he was "not aware" that ISAF had been approached for assistance.
The Taliban denied it was behind the attack, with spokesman Zabihullah Mujahid saying: "We condemn this attack on a hospital... whoever has done this wants to defame the Taliban."
Militants in Afghanistan frequently target the Afghan police and other government employees as well as foreign forces in their near decade-long insurgency.
But civilians are the biggest casualties in the war, with 2,777 killed last year, according to the United Nations.
The huge blast comes days after Obama announced that 33,000 US forces would leave Afghanistan by the end of next summer.
All foreign combat forces are due to pull out of the country by the end of 2014. There are currently up to 150,000 foreign forces in Afghanistan, including around 99,000 from the US.
Some analysts fear that Afghan security forces may struggle to contain the insurgency, which has hit record violence levels, as withdrawals start to get under way.
Saturday's attack came as Afghan President Hamid Karzai told a counterterrorism summit in Tehran that despite his government's efforts, militancy was on the rise in both his country and the region.
"Unfortunately, despite all the achievements in the fields of education, infrastructure and reconstruction, not only has Afghanistan not yet achieved peace and security, but terrorism is expanding and threatening more than ever Afghanistan and the region," he told the opening session.
The two-day summit is being attended by the heads of state of six regional countries, including Afghan neighbours Iran and Pakistan.
"Peace, stability in our country are truly threatened. All countries in the region must help fight terrorism, since terrorism has such power that no nation can be spared," Karzai told fellow leaders.
On Friday, 10 people were killed by a bicycle bomb which went off in a busy bazaar in Khad Abad district of the northern province of Kunduz.
"Ten people were killed including a police soldier and 24 others were wounded including 18 men, five women and a police member," the Afghan interior ministry said in a statement.
The explosives were planted in a bicycle near an ice-cream shop, the statement added. Police have launched an investigation into the blast, which local officials blamed on the Taliban.
The north of Afghanistan is usually more stable than the volatile south and east but has seen an upsurge of violence in recent times.
Separately, ISAF said one member of the foreign forces died after an insurgent attack in eastern Afghanistan Saturday, without giving further details in line with policy.
Eastern Afghanistan sees some of the worst fighting in the country along the porous border with Pakistan, where militants have hideouts.
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