ROSTOV-ON-DON, Russia - The death toll in a suicide attack on a Russian military hospital near Chechnya that officials suspect was carried out by Chechen rebels climbed to 41 yesterday, officials said.

The suicide attacker rammed a truck packed with explosives through the gates of the four-story red brick hospital Friday night in the city of Mozdok in the North Ossetia region, the region's Emergency Situations Minister Boris Dzgoyev said. He reported that at the moment of the explosion, there were 98 patients and 21 employees inside the building, which collapsed like a house of cards.

Robert Kireyev, a spokesman for the Emergency Situation Ministry in southern Russia, said the death toll reached 41 by yesterday evening and that 36 bodies had been identified. He said 59 of the 79 people injured remained hospitalized, 10 of them in critical condition.

Dzgoyev said many of the injured were soldiers who were recovering from wounds suffered in Chechnya, where Russia's second war against rebels in a decade has lasted nearly four years.

Russian Defense Minister Sergei Ivanov broke off his summer vacation and arrived at the blast site yesterday at the request of President Vladimir Putin. He told reporters that the act of terrorism was possible because special military security orders were disobeyed. He said the chief of the Mozdok military garrison had been suspended pending an investigation.

Surrounded by heavily armed soldiers, Ivanov was shown on Russian television inspecting the fence where the suicide driver entered the hospital grounds, and observing the cleanup effort.

About 700 rescue workers assisted by sniffer dogs picked through the rubble with heavy machinery, searching for more victims and clearing the blast site. Officials said they expected the death toll to rise as the rubble is cleared.

"The search continues for the dead and the wounded who could be remaining under the debris," Ivanov said.

Major General Nikolai Lityuk, deputy head of the regional Emergency Situations Ministry, said after the blast that a Kamaz truck broke through the hospital gates, drove past some tents, pulled up at the reception office and exploded, leaving a crater 8 meters across and 3 meters deep.

"We were the first to arrive. Near the checkpoint of the hospital there were charred corpses," a medical assistant from Mozdok's central hospital, Galina, said on Rossiya television. "Tents that were put up near the main building were all gone, there was one wall left from the main building."

The force of the explosion was equivalent to at least a ton of TNT, Interfax quoted Russian Deputy Prosecutor General Sergei Fridinsky as saying.

Lityuk said preliminary information indicated one person was in the truck during the attack, the latest deadly assault aimed at the Russian military in and around Chechnya and another bloody blow to the Kremlin's efforts to bring order in the region.

Alina Totykova, deputy head of the main regional hospital in North Ossetia's capital Vladikavkaz, said there was a serious shortage of medicine, anesthetics and bandages and a severe shortage of blood, adding that an appeal for people to give blood would be broadcast on local television.

There was no immediate claim of responsibility for the attack - the latest in a surge of suicide bombings that have killed more than 100 people in and near Chechnya and in Moscow since May - but Russian officials said they suspected Chechen rebels.

Fridinsky said that because military personnel who fought rebels in Chechnya were being treated at the hospital, "we are inclined to view this crime as an act of revenge," he said on NTV. "We can definitely say that it is not a question of a criminal dispute, but a well-planned terrorist act," he said.

Mozdok is the headquarters for Russian forces fighting in Chechnya and has been targeted by attackers before. In June, a female suicide attacker detonated a bomb near a bus carrying soldiers and civilians to work at a military airfield near Mozdok, killing at least 16 people.

In May in Chechnya, a truck-bomb attack similar to Friday's blast killed 60 people and a woman blew herself up at a religious ceremony, killing at least 18. Last month, a double suicide bombing at a rock concert in Moscow killed 15 bystanders.

Putin expressed condolences to relatives of the victims and ordered an investigation, the Kremlin said. He met in the Kremlin with Nikolai Patrushev, director of the Federal Security Service and Prosecutor General Vladimir Ustinov to discuss the attack on the hospital.