| Collector | Larsen, K. |
| Number | 2865 |
| Collected with | T. Santisuk & E. Warncke |
| Country | Thailand |
| Subpart | Northern |
| County | |
| Locality | Pong Pho 12 km N of Doi Chieng Dao |
| Coordinates | |
| Minimum elevation (m) | 1200 |
| Maximum elevation (m) | 1200 |
| Start date | 1968/07/30 |
| End date | 1968/07/30 |
| Family | Balsaminaceae |
| Identification | Impatiens santisukii T.Shimizu |
| Determined by | P. Suksathan & P. Triboun |
| Identification qualifier | |
| Field notes | Hillside evergreen |
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