“We didn’t know what to do — it was like our brains stopped working,” said one intern who escaped the building after an Air India jet crashed, killing at least 260 people.

The medical students in the western Indian city of Ahmedabad were eating lunch on Thursday when an Air India passenger plane crashed into their dining hall.

“We only heard a blast,” said Mohit Chavda, an intern who was halfway through his meal of lentils, cabbage and bread when the disaster struck. “Then we just saw the dust and smoke coming inside with force.”

In the aftermath of India’s worst aviation disaster in decades, the ripped-off tail of a Boeing 787 Dreamliner could be seen jutting out of the building, as firefighters quelled the flames. In the dining hall, lunch plates were left half finished.

Image The medical students’ dining hall after the crash.Credit…Ajit Solanki/Associated Press

While police officials have put the death toll from the crash at 269 people, they have cautioned that a final figure will take time to ascertain. Many of the bodies are charred and are being identified and counted through DNA testing.

All but one of the 242 passengers and crew aboard the jet, which was headed to London, are confirmed dead,the airline said. Rescue personnel at the site, as well as doctors and security officials, suggested that at least three dozen other people had been killed on the ground.

Among the dead were at least four medical students, said Minakshi Parikh, the dean of B.J. Medical College, whose campus is near the end of the runway of the airport. Dozens of others are being treated at the city’s main hospital.

“Most of the students escaped, but 10 or 12 were trapped in the fire,” Ms. Parikh said.

Verified video shows the plane descending, almost as if on a glide, and then a fireball rising in its place. Photos and verified videos from the crash site show widespread carnage and medical workers carrying the bodies of victims into ambulances.

Images emerging from the scene show a blackened tangle of wreckage. The aircraft appears to have broken into large pieces, with one wing lying on a roadway. Firefighters could be seen spraying down burned-out buildings and sooty, cracked trees as they stepped carefully around the hunks of debris.

Dr. Bharat Ahir, who reached the scene soon after the crash, said he feared that casualties in a nearby residential complex, a multistory block where doctors and their families live, could outnumber those at the dining facility.

“The plane’s back part is stuck in the dining hall, and the front hit the residential building,” he said.

Mr. Chavda, the intern, said the building’s proximity to the airport means residents are used to high-intensity noise, particularly from air force engines. So at first they thought it might just be a plane flying too low.

Then it went dark.

“We didn’t know what to do — it was like our brains stopped working,” he said. “We just got up and started running. We couldn’t see anything, but there is muscle memory: We knew which way the exit was.”

Only after they escaped did they grasp what happened.

“We only realized that there had been a plane crash once we got downstairs and saw the airplane’s tail,” Mr. Chavda said.

He said he had immediately feared that the residential complex, separated from the dining hall by just a narrow road, had sustained worse damage.

“The fourth floor walls were broken,” he said. “The doctors were at the hospital on duty, and their families were in the building. There are many casualties among them.”

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Wreckage from the plane at the site of the crash. Credit…Amit Dave/Reuters