Rescuers brought out seemingly dead patients as anxious relatives stared, hoping their worst fears would not come true, as thick black smoke billowed from the Annex 1 new building of Kolkata's AMRI hospital that had caught fire in the early hours of Friday.

A steady stream of patients, blackened by soot and lifted with the help of cloth and rope, continued to be brought out while enraged relatives and locals vented their ire at the state and hospital administration for sheer inefficiency.

"What's the use of coming now? He is already dead. All are dead. The administration is hopeless, useless," shouted Pradeep Sarkar at the firemen. His father-in-law had been admitted there Thursday night with a heart ailment.

Sarkar, who was at the hospital through the night, accused the fire engines of coming late and being ill-equipped. He said the sky lift came only around 7 a.m. whereas the fire started around 3 a.m.

"They (firemen) came with manual ladders. Had the sky lift come earlier, many people could have been saved. There are around 160 patients inside. All are dead -- so is my father-in-law," said Sarkar.

Some patients could be seen lying motionless, making many suspect that they had been asphyxiated on the hospital beds.

Relatives of patients lurched from official to official to know the whereabouts of patients, only to be met with a deafening silence.

"I have been looking for my aunt since 3 a.m. Neither the hospital authorities nor police have any clue about where the patients are. I do not even know if my aunt is alive," said Jayanta Bose, whose aunt Meera Bose was being treated in the hospital.

There was complete mayhem as hundreds of local people tried to enter the hospital building to rescue patients, but were denied entry by the hospital staff.

"We saw smoke coming out of the building around 2 in the morning and immediately many of us gathered and came here to extend help. But we were denied entry. Had we been allowed inside, so many people would not have died. They have mostly died of suffocation because the fire did not reach the higher part of the building," said Ronojit Mondal, a local who along with many other locals have been aiding the rescue work.

"When we reached here we could see some patients wailing for help atop the windows but we were not allowed to go inside by the hospital men. We pleaded, threatened and pushed but could not manage to get inside. They must be punished with death for killing these people," said Irfan, another infuriated local.

When West Bengal Municipal Affairs Minister Firhad Hakim claimed the death toll was 20, locals said it would be much higher as many patients were still trapped inside.

Sadly, there were proved right, when Chief Minister Mamata Banerjee announced that 40 bodies had been taken to the state-run SSKM Hospital from AMRI.

As Banerjee reached the spot, the patience of relatives gave way and they rushed towards her with their grievances. Police tried to pacify the crowd while Banerjee herself pleaded on the microphone for people to calm down.

Rescue operations continued and so did the flow of rescued patients though a look at them suggested, most of them were lifeless bodies.