Fourteen deaths were reported in India with seven others in Nepal, according to each nation's Home Ministry. More than 90 have been injured in India.
The quake struck the northern Indian state of Sikkim, where seven people died, causing damage in West Bengal, Bihar, Assam, Arunachal Pradesh and Meghalaya. Five deaths were reported in West Bengal and two others in Bihar.
The dead include three in Nepal's capital of Kathmandu, who died when a wall of the British embassy collapsed, according to Kedar Rijal, Kathmandu police chief. They included an 8-year-old girl, her father and a third person.
The British Foreign Office confirmed a "compound perimeter wall" of the embassy collapsed, adding that its ambassador has met with the community and offered condolences.
Police said in a statement that two more people died in the Nepalese town of Dhara, about 217 miles east of Kathmandu. About a dozen people were injured when they jumped from their houses during the quake, police said.
The locations of the other two fatalities were not immediately available.
Already, 300 civilians had been rescued in one such effort near Sikkim's border with China, said Indo-Tibetan Border Police spokesman Deepak Kumar Pandey. Some 22 tourists - all of them Indians - were also rescued in the same area.
The deaths, damage and recovery efforts came after a total of three quakes struck the region in rapid succession in a mountainous region.
The quakes set off landslides, which - along with heavy rains - were blocking roads and hampering rescue efforts, Pandey said. He expressed fears that the toll, as far as deaths and damage, could be more than is now known, anticipating more will be known once the sun rises on Monday.
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