First create the database and table, manually adding the columns. In which column to be primary key. You should right click this column and set primary key and set the seed value of the primary key.
Actually last way is healthier and serial. You can look the FK/PK Constraint names (dbo.dbname > Keys > ..) but if you do not use a constraint, MSSQL auto-creates random FK/PK names. You will need to look at every change (alter table) you need.
I recommend that you set a standard for yourself; the constraint should be defined according to the your standard. You will not have to memorize and you will not have to think too long. In short, you work faster.