A 42-year-old gunman killed six people at a hospital waiting room in the eastern Czech city of Ostrava before fleeing and fatally shooting himself in the head, police have said.
It was the worst shooting in the Czech Republic, where gun crime is relatively rare, since a man shot eight people dead and then killed himself at a restaurant in Uhersky Brod in 2015.
It was unclear what motivated the shooting, which happened in the early morning at the outpatient clinic of the University Hospital in Ostrava, a city of 290,000 people 350km east of the capital Prague and near the border with Poland.
Prime Minister Andrej Babis told reporters it was an "individual act".
"He came home and announced he had shot people, and that he is going to shoot himself," Mr Babis told a televised news conference.
He said the attacker's mother was co-operating with police.
The shooter fled the hospital after the attack, prompting a manhunt involving hundreds of officers.
He later shot himself in the head at his car with a police helicopter flying overhead.
He died about half an hour later after failed efforts to resuscitate him, Interior Minister Jan Hamacek said.
The shooter was identified as Ctirad Vitasek, a construction technician at the AZ-INTERGRIPS company based in Opava, just north-east of Ostrava, by the firm's Chairman Ales Zygula.
Mr Zygula told Reuters Vitasek had been on medical leave for the past month and a half.
He also told Czech Radio that Vitasek was convinced he was seriously ill and that no one wanted to cure him.
Police said they received calls at 7.19am (6.19am Irish time) and officers were on the scene five minutes later.
Hospital director Jiri Havrlant told reporters five people died in the attack and one died in surgery.
Another two were seriously injured but no medics were hurt, he said.
The victims, all adults, had been shot at close range, he said.
Police said they were four men and two women, amending earlier information that five of the victims were men.
The head of the regional police department, Tomas Kuzel, said the attacker, who did not have a gun licence, was silent as he carried out the shooting with a 9-millimetre Czech handgun.
The suspect had a criminal record including instances of violence and theft, he said.