
Eight people, most of them women, were wounded in the attack - one of three cross-border raids that took place about the same time overnight.
The four civilians were killed when rockets landed in the eastern town of Khost after being launched from about 300 metres inside Pakistani territory, Arsala Jamal, the provincial governor, said on Sunday.
A rocket fired from Pakistan hit a hospital in the northeastern Afghan province of Kunar in a separate incident.
One man was killed and a man and woman were wounded in the attack the provincial governor said.
Three artillery shells fired from Pakistan landed in an Afghan army camp and three more landed close to a Nato base in the eastern Afghan province of Paktika, alliance officials said.
Nato forces returned fire. No casualties were reported.