Depends on the mechanism, but the simpler/traditional methods just have the water fall from the tank to the bowl. Many newer ones (especially meant for commercial) have a pressurized tank, that is the tank is actually a balloon and the water is pushed into the tank at line pressure (usually 40psi or so), when you flush it can then release the water at line pressure (40psi) which forces it though the toilet.
Commercial public restroom types (without a tank), skip the tank entirely and just connect the water line straight to the toilet which has the same effect (but requires a very large water line to supply the flow rates).
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