In a press conference on Sunday, Colombian President Juan Manuel Santos confirmed the number of dead and said that 122 people had been pulled from the water in the wake of the accident.
The cause of the shipwreck was unknown as of Sunday night.
Lorena Salazar, who survived the tragedy, told local media: "Those on the first and second floors sank immediately".
"We started to hear screams and noise and then people started telling us about a boat that had gone down with a lot of people".
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Six passengers perished and three remain hospitalized after the boat sank in Guatape, near Medellin.
The reservoir, which was created as a result of a controversial dam built in the late 1970s, is widely recommended as a place to visit, with boat rides on the water being cited. "It all happened in a few minutes", said fire service captain Luis Bernardo Morales.
Regional government official, Victoria Eugenia Ramirez, said the El Almirante was booked to capacity when it set off.
Survivors told local media the boat appeared to be overloaded and before it went down they heard a loud crunching sound and numerous passengers were not provided with life vests.
The large reservoir, about an hour from the central city of Medellin, is a popular tourist destination.
It was a long holiday weekend in Colombia and the El Almirante ferry was filled with tourists.
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