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Fourteen coaches of the train travelling with more than 500 passengers rolled off track a little after 3 am in Pukhraya, 60 km from Kanpur, when most passengers were sleeping.
TV visuals showed the coaches smashed up against each other and rescue workers trying to cut through crumpled metal to pull out trapped passengers.
Witnesses were jolted awake when they heard a bang and were thrown around. "We heard a deafening noise... I am lucky to be alive and safe," a passenger said.
More bodies were pulled out from the two coaches that fell on the side, said Daljeet Singh Choudhary, a senior police officer. Hours after the crash, a team of army personnel, doctors joined some 250 rescue workers.
Many survivors were moved to a nearby town so they could leave by trains or buses.
It is feared that the number of deaths will rise because rescuers have not been able to access one of the coaches.
Prime Minister Narendra Modi said he was "anguished beyond words" and added that he had spoken to Railways Minister Suresh Prabhu who was monitoring the situation closely.
In tweets, Suresh Prabhu said he had ordered an inquiry and "strictest possible action will be taken against those who could be responsible."
Top railway officials said a fault in the tracks may have caused the accident, which, they said, was the worst they had seen in a long time.
Indian Railways is the world's fourth largest network, ferrying more than 20 million each day. Another train accident in Uttar Pradesh in March last year left 39 dead and injured 150.
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