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The game is played with a set of Chinese dominoes. Heaven is the top rank tile of the civilian suit; Nine is the top rank tile of the military suit of the domino set.
"Tien Gow" is sometimes spelled Tin Kau, and is the transliteration of two Chinese characters (天九) in Cantonese: Heaven and Nine. In Mandarin, it is pronounced as Tian1Jiu3.