Ukraine accused Russian forces of hitting a psychiatric hospital near the eastern Ukrainian town of Izyum on Friday in what the regional governor called "a brutal attack on civilians."
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Oleh Synegubov, governor of the Kharkiv region, said 330 people had been at the hospital at the time, some of them confined to wheelchairs or unable to move, and that 73 had been evacuated.
The number of casualties was being established, he said.
"This is a war crime against civilians, genocide against the Ukrainian nation," Synegubov wrote on the Telegram messaging app.
Kharkiv is under relentless bombardment from Russian forces, the city's mayor said in a televised interview on Friday.
"As of today, 48 (of the city's) schools have been destroyed," said Mayor Ihor Terekhov. The city has a peacetime population of about 1.4 million.
According to the International Organization for Migration says 2.5 million people have fled Ukraine since Russia invaded more than two weeks ago.
IOM spokesman Paul Dillon said in a text message that the figures, taken from national governments, were up to date through Friday morning.
He said that more than 1.5 million refugees have gone to neighboring Poland and that some 116,000 of the refugees are "third-country nationals," not Ukrainians.
The UN high commissioner for refugees, Filippo Grandi, also gave the 2.5 million total for refugees and said his agency estimates that about 2 million people were displaced inside Ukraine, as well.
Ukrainian authorities announced plans for several evacuation and humanitarian aid delivery routes Friday, with the support of the Red Cross.
The top priority remained freeing people from the besieged city of Mariupol and getting aid to its hungry, thirsty, freezing and terrified population.
Deputy Prime Minister Iryna Vereshchuk said in a video message Friday that Ukrainian authorities were trying yet again to send aid into Mariupol and bring evacuees out to the city of Zaporizhzhia. Repeated previous attempts have failed, as aid and rescue convoys were targeted by Russian shelling.
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Vereshchuk said buses would be sent Friday to multiple Kyiv suburbs to bring people to the capital, and to bring aid to those staying behind.
She also announced efforts to create new humanitarian corridors to bring aid to people in areas occupied or under Russian attack around the cities of Kherson in the south, Chernihiv in the north and Kharkiv in the east.
Meanwhile, Russian President Vladimir Putin said at a Russian security council meeting on Friday that it went "against all norms" for foreign volunteers to join up to fight alongside Ukraine. Putin said he wanted to allow volunteers to fight against Ukrainian forces and approved handing over captured Western missile systems to Russian-backed rebel fighters.
Russian Defense Minister Sergei Shoigu proposed handing over American made anti-tank systems such as Javelin and Stinger to fighters from the rebel regions of Luhansk and Donetsk.
Putin, speaking at a Russian security council meeting, said he supported such an idea. He also said that those who wanted to volunteer to fight with Russian-backed forces should be allowed to. Shoigu said there were 16,000 volunteers in the Middle East who were ready to come to fight with Russian-backed forces.
