Generally we will be displaying buttons on both bottom and top of the page using below code
Code
<apex:page standardController="lead" extensions="appointmentcontroller">
<apex:form>
<apex:pageBlock>
<h1>Congratulations</h1>
This is your new Page
<apex:pageBlockButtons>
<apex:commandButton action="{!saveAndCongrat}" value="Save" reRender="test"/>
<apex:commandButton value="Cancel" action="{!cancelredirect}" />
</apex:pageBlockButtons>
</apex:pageBlock>
</apex:form>
</apex:page>
Output
What if you want to display button only on top or only on bottom ? then change the above code to below format by adding location attribute where you can specify top, bottom, or both - it defaults to both in pageBlockButtons
Code
<apex:page standardController="lead" extensions="appointmentcontroller">
<apex:form>
<apex:pageBlock>
<h1>Congratulations</h1>
This is your new Page
<apex:pageBlockButtons location="bottom">
<apex:commandButton action="{!saveAndCongrat}" value="Save" reRender="test"/>
<apex:commandButton value="Cancel" action="{!cancelredirect}" />
</apex:pageBlockButtons>
</apex:pageBlock>
</apex:form>
</apex:page>
Output