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Derived from an ancient Chinese gambling game of Pai gow, played with dominoes, in the United States, 5the game has gained immense popularity with the gamblers ever since it was modified and introduced as Pai gow poker or double-hand poker where instead of dominoes, cards with poker hand values and rank are used to play.

The rules of gameplay are simple. There is a standard 52-card deck and an extra joker card and the gaming table has six players along with dealer. Anyone who can beat the banker, designated by either the dealer or anyone among the players, wins the pot. In course of the game, each player has to complete two poker hands, a 5-card and a 2-card hand out of the seven cards he is dealt with stipulation that his 5-card hand must be valued more than the 2-card hand. The 2-card hand is variously called the front, top, small or minor hand while the 5-card hand is named the behind, bottom or big.

The game of Pai gow poker starts when the cards are shuffled and the seven participants, six players and the dealer, get seven cards with their face down. In case there is less than six players, all the hands are still dealt so that ultimately only four cards remain unassigned. For the absent player, his hand is placed along with discard of four unused cards. This game is positional with all the participants given a number and the first rank given to the banker, whether he is the dealer or any other player and the subsequent numbers are allotted in anti-clockwise fashion. To determine who would open dealing, any one of the seven numbers is chosen at random and the game proceeds in that anti-clockwise manner. Sometimes three 6-sided dices are rolled and the number that is totaled is used to count the players from position one in clockwise and thus the dealer is decided.