As a datapoint, this is what an Australian ballot for the House of Reps looks like:
You get one of these and a pencil; number the boxes in order of preference. They’re counted entirely by hand; no machines involved at all. It seems to work just fine for us, despite having twice the per-capita voter turnout of a US election.
OTOH, this is one of our ballots for the Senate…
Still hand-marked and hand-counted, though.
It’s traditional to have a whinge about the size of it, but that isn’t really a problem. People who can’t be bothered filling out the whole thing just mark their preferred party at the top (“voting above the line”), and their preferences are distributed according to a list published by the party in question.
