Sammy Tubs the Boy Doctor
There is nothing quite like Sammy Tubbs the Boy Doctor and Sponsie, the Troublesome Monkey: A Book for Private Reading. Written by E.B. Foote, M.D. in 1874 it carried some basic biological information, mostly aimed at young audiences.
On page 180½ the diagram of the female internal organs is meant to be torn out if need. The note reads "This leaf can be cut out if thought advisable."
To be fair, the male genitalia are printed on 180¾ for the same purpose.