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The ace of spades with a skull in it, or "Death head spade" was most commonly depicted during the Vietnam War. American GI's as part of a PSYOP or psychological operation would leave these cards on the dead bodies of the enemy to "let charlie know who did this" most commonly the reverse side of the card would have the unit of assignment ie. 1st Cav Division or at that time they were most commonly known as the Air Cav.

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Q: What does the Tattoo of a black spade with a skull inside mean?
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