The first outward change of puberty in girls is:  Rapid growth to reach the adult height and weight.  Enlargement and development of the breasts  Increase in clear vaginal secretions.  Onset of menstruation .

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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The first outward change of puberty in girls is: 

  1. Rapid growth to reach the adult height and weight. 
  2. Enlargement and development of the breasts 
  3. Increase in clear vaginal secretions. 
  4. Onset of menstruation .
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