Many roads and bridges were reported damaged, making rescue operations difficult. But historic churches dating from the Spanish colonial period suffered the most. Among them was the country's oldest, the 16th-century Basilica of the Holy Child in Cebu, which lost its bell tower.
Nearly half of a 17th-century limestone church in Loboc town, southwest of Carmen, was reduced to rubble.
The highest number of dead — 18 — were in the municipality of Loon, 42 kilometers (26 miles) west of Carmen, where an unknown number of patients were trapped inside the Congressman Castillo Memorial Hospital, which partially collapsed. Rescuers were working to reach them, said civil defense spokesman Maj. Reynaldo Balido.
As night fell, the entire province was in the dark after the quake cut power supplies. Windy weather and rain also forced back a military rescue helicopter.
Authorities were setting up tents for those displaced by the quake, while others who lost their homes moved in with their relatives, Bohol Gov. Edgardo Chatto said.