Three American doctors have been shot dead by a hospital security guard in Kabul.
A father and son were among the victims.
The pair were visiting a pediatrician who had worked in Afghanistan for seven years. He was also killed.
Authorities say two other American doctors suffered gunshot wounds.
The killer, a member of the Afghan Police Protection Force, attempted to take his own life but failed and underwent surgery at the CURE International Hospital, the scene of the murders.
The shootings came as the country braces itself for a presidential run-off between Abdullah Abdullah and Ashraf Ghani.
Both men are well ahead of the field after the first vote with neither securing an outright majority.