Forming sets and runs using a standard deck of cards is the fundamental element of Rummy East. The goal is to meld cards into playable combinations while minimizing the number of points remaining in slots on linehand when a player is eliminated. This game is typically played with two to six players. Depending on the number of players, each player is dealt a set number of cards, typically seven or ten. With one card face-up to begin the discard pile, the remaining cards form a draw pile. Each player takes a turn drawing cards from either pile, then at the conclusion of their turn, they discard one card.

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