I use both
Being a Systems Administrator the majority of my work is done on the PC and most of my tasks are generated by email (Outlook). However, there are some which will be on paper, so I do have a 43 folder tickler system as well.
I have Outlook set up in pretty much the same way that Thomas describes with the task start date as the tickler. I love the feature in Outlook 2010 where you can now create quick actions, one of which is to create a task from an email - much quicker and simpler than the old method of dragging the email to a particular task list. One of my daily recurring tasks which starts at 8.30 is to check my physical tickler file so I never forget about it. I've also set Outlook to open up with tasks so I can see straight away things I need to start that day.
To be fair my physical tickler never really has much in it, but I can't bring myself to get rid of it. Like a previous poster stated, I love the act of physically checking it day. Although I am mostly a gadget freak, I do still love paper as well!