The strike was called by the Haryana Civil Medical Services Association, which represents government doctors in the state.

The doctors' demands include the formation of a specialist cadre for them and a career progression scheme that ensures parity with their central government peers.

The association called for a shutdown of health services in government hospitals to protest against the non-fulfilment of doctors' demands.

The state government has urged the body to consider the impact of the strike on patients.

"Doctors of various government health institutions have proceeded on an indefinite strike across the state," association president Dr Rajesh Khyalia said.

On Wednesday, four association members, including Khyalia, started an indefinite hunger strike in front of the office of the Health Services director general in Panchkula.

The other demands of the doctors include no direct recruitment of senior medical officers and reduction in the bond amount for postgraduate courses.

On the government's invitation for talks on Thursday, Khyalia said, "We will attend the meeting but if there is no outcome, then our strike will continue indefinitely."

At many places, including Panipat and Gurugram, long queues of patients were seen in outpatient departments (OPDs) of district hospital, with many saying they were told that the doctors were on strike.

At a few other places, some patients in OPDs said they were attended to by doctors undergoing postgraduate training, those doing internship and retired doctors.

Khyalia had said on Wednesday, "Over the past several months, we have been given repeated assurances pertaining to our various demands but those remain unfulfilled. So, we have decided to observe a total shutdown of health services, including OPD, emergency, post-mortem from Thursday."

"On July 18, we were assured by the additional chief secretary, health, that a notification would be issued before July 24 pertaining to two demands -- assured career progression and the bond issue -- but nothing happened. We had told the government a month ago that we would be compelled to shut down all services from July 25 (if the demands were not met)," he had added.

In a letter to the association on Wednesday, Health Minister Kamal Gupta urged the doctors to consider the impact of their strike on the general public.

"I understand that ... numerous pressing demands (have been) put forth by your members and I want to assure you that these concerns are being taken very seriously. Recently, I held a productive meeting with the chief minister and other higher officers to discuss these matters extensively. We recognise the importance of your demands and are actively working towards a resolution that will be satisfactory to all parties involved," he had said in the letter.

"However, I urge each one of you to consider the impact of a strike on our patients and the general public. We have a responsibility to ensure that healthcare services remain uninterrupted, especially for those who rely on us in their times of need," the minister had said.

On July 15, the government doctors observed a two-hour strike to press for their demands. The strike had affected OPD services in government health care institutions across the state.

According to the association, doctors have to submit two bonds of Rs 1 crore each for admission to postgraduate courses and demand that it be reduced considerably.

On the direct recruitment of senior medical officers, the association has said it would block the growth of hundreds of medical officers awaiting promotion to the post after completion of 20 years of service.